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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Synonyms
- Isthmic spondylolysis (IS)
Definitions
- Unilateral or bilateral defects in pars interarticularis (PI) thought to result from repetitive stress injury
- Pars is junction of pedicle, lamina, and facet
- Unilateral or bilateral defects in pars interarticularis (PI) thought to result from repetitive stress injury
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Nonvascular Interventions
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Berger RG et al: Spondylolysis 2019 update. Curr Opin Pediatr. 31(1):61-8, 2019
- Selhorst M et al: Prevalence of spondylolysis in symptomatic adolescent athletes: an assessment of sport risk in nonelite athletes. Clin J Sport Med. 29(5):421-5, 2019
- Lawrence KJ et al: Lumbar spondylolysis in the adolescent athlete. Phys Ther Sport. 20:56-60, 2016
- Borg B et al: Pedicle marrow signal hyperintensity on short tau inversion recovery- and T2-weighted images: prevalence and relationship to clinical symptoms. AJNR Am J Neuroradiol. 32(9):1624-31, 2011
- Lee JY et al: Surgeons agree to disagree on surgical options for degenerative conditions of the cervical and lumbar spine. Spine (Phila Pa 1976). 36(3):E203-12, 2011
- Leone A et al: Lumbar spondylolysis: a review. Skeletal Radiol. 40(6):683-700, 2010
- Lastfogel JF et al: Sacral fractures following stand-alone L5-S1 anterior lumbar interbody fusion for isthmic spondylolisthesis. J Neurosurg Spine. 13(2):288-93, 2010
- Baek OK et al: Extraforaminal lumbar interbody fusion for the treatment of isthmic spondylolisthesis. J Spinal Disord Tech. 22(3):219-27, 2009
- Sakai T et al: Significance of magnetic resonance imaging signal change in the pedicle in the management of pediatric lumbar spondylolysis. Spine (Phila Pa 1976). 35(14):E641-5, 2010
- Ekman P et al: Predictive factors for the outcome of fusion in adult isthmic spondylolisthesis. Spine (Phila Pa 1976). 34(11):1204-10, 2009
- Don AS et al: Facet joint orientation in spondylolysis and isthmic spondylolisthesis. J Spinal Disord Tech. 21(2):112-5, 2008
- Park P et al: Minimally invasive transforaminal lumbar interbody fusion with reduction of spondylolisthesis: technique and outcomes after a minimum of 2 years' follow-up. Neurosurg Focus. 25(2):E16, 2008
- McTimoney CA et al: Current evaluation and management of spondylolysis and spondylolisthesis. Curr Sports Med Rep. 2(1):41-6, 2003
- Merbs CF: Asymmetrical spondylolysis. Am J Phys Anthropol. 119(2):156-74, 2002
- Logroscino G et al: Spondylolysis and spondylolisthesis in the pediatric and adolescent population. Childs Nerv Syst. 17(11):644-55, 2001
- Standaert CJ et al: Spondylolysis. Phys Med Rehabil Clin N Am. 11(4):785-803, 2000
- Saifuddin A et al: The value of lumbar spine MRI in the assessment of the pars interarticularis. Clin Radiol. 52(9):666-71, 1997
- Ulmer JL et al: MR imaging of lumbar spondylolysis: the importance of ancillary observations. AJR Am J Roentgenol. 169(1):233-9, 1997
- Ohmori K et al: Vertebral slip in lumbar spondylolysis and spondylolisthesis. Long-term follow-up of 22 adult patients. J Bone Joint Surg Br. 77(5):771-3, 1995
- Ulmer JL et al: Distinction between degenerative and isthmic spondylolisthesis on sagittal MR images: importance of increased anteroposterior diameter of the spinal canal ("wide canal sign"). AJR Am J Roentgenol. 163(2):411-6, 1994
- Jinkins JR et al: Spondylolysis, spondylolisthesis, and associated nerve root entrapment in the lumbosacral spine: MR evaluation. AJR Am J Roentgenol. 159(4):799-803, 1992
- Reynolds R: Spondylolysis and Spondylolisthesis. Seminars in Spine Surgery. 4:235-47, 1992
- Danielson BI et al: Radiologic progression of isthmic lumbar spondylolisthesis in young patients. Spine. 16(4):422-5, 1991
- Frennered AK et al: Natural history of symptomatic isthmic low-grade spondylolisthesis in children and adolescents: a seven-year follow-up study. J Pediatr Orthop. 11(2):209-13, 1991
- Rossi F et al: Lumbar spondylolysis: occurrence in competitive athletes. Updated achievements in a series of 390 cases. J Sports Med Phys Fitness. 30(4):450-2, 1990
- Johnson DW et al: MR imaging of the pars interarticularis. AJR Am J Roentgenol. 152(2):327-32, 1989
- Rossi F: Spondylolysis, spondylolisthesis and sports. J Sports Med Phys Fitness. 18(4):317-40, 1978
- Wiltse LL et al: Classification of spondylolisis and spondylolisthesis. Clin Orthop. (117):23-9, 1976
- Wiltse LL: Spondylolisthesis. West J Med. 122(2):152-3, 1975
Related Anatomy
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Synonyms
- Isthmic spondylolysis (IS)
Definitions
- Unilateral or bilateral defects in pars interarticularis (PI) thought to result from repetitive stress injury
- Pars is junction of pedicle, lamina, and facet
- Unilateral or bilateral defects in pars interarticularis (PI) thought to result from repetitive stress injury
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Nonvascular Interventions
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Berger RG et al: Spondylolysis 2019 update. Curr Opin Pediatr. 31(1):61-8, 2019
- Selhorst M et al: Prevalence of spondylolysis in symptomatic adolescent athletes: an assessment of sport risk in nonelite athletes. Clin J Sport Med. 29(5):421-5, 2019
- Lawrence KJ et al: Lumbar spondylolysis in the adolescent athlete. Phys Ther Sport. 20:56-60, 2016
- Borg B et al: Pedicle marrow signal hyperintensity on short tau inversion recovery- and T2-weighted images: prevalence and relationship to clinical symptoms. AJNR Am J Neuroradiol. 32(9):1624-31, 2011
- Lee JY et al: Surgeons agree to disagree on surgical options for degenerative conditions of the cervical and lumbar spine. Spine (Phila Pa 1976). 36(3):E203-12, 2011
- Leone A et al: Lumbar spondylolysis: a review. Skeletal Radiol. 40(6):683-700, 2010
- Lastfogel JF et al: Sacral fractures following stand-alone L5-S1 anterior lumbar interbody fusion for isthmic spondylolisthesis. J Neurosurg Spine. 13(2):288-93, 2010
- Baek OK et al: Extraforaminal lumbar interbody fusion for the treatment of isthmic spondylolisthesis. J Spinal Disord Tech. 22(3):219-27, 2009
- Sakai T et al: Significance of magnetic resonance imaging signal change in the pedicle in the management of pediatric lumbar spondylolysis. Spine (Phila Pa 1976). 35(14):E641-5, 2010
- Ekman P et al: Predictive factors for the outcome of fusion in adult isthmic spondylolisthesis. Spine (Phila Pa 1976). 34(11):1204-10, 2009
- Don AS et al: Facet joint orientation in spondylolysis and isthmic spondylolisthesis. J Spinal Disord Tech. 21(2):112-5, 2008
- Park P et al: Minimally invasive transforaminal lumbar interbody fusion with reduction of spondylolisthesis: technique and outcomes after a minimum of 2 years' follow-up. Neurosurg Focus. 25(2):E16, 2008
- McTimoney CA et al: Current evaluation and management of spondylolysis and spondylolisthesis. Curr Sports Med Rep. 2(1):41-6, 2003
- Merbs CF: Asymmetrical spondylolysis. Am J Phys Anthropol. 119(2):156-74, 2002
- Logroscino G et al: Spondylolysis and spondylolisthesis in the pediatric and adolescent population. Childs Nerv Syst. 17(11):644-55, 2001
- Standaert CJ et al: Spondylolysis. Phys Med Rehabil Clin N Am. 11(4):785-803, 2000
- Saifuddin A et al: The value of lumbar spine MRI in the assessment of the pars interarticularis. Clin Radiol. 52(9):666-71, 1997
- Ulmer JL et al: MR imaging of lumbar spondylolysis: the importance of ancillary observations. AJR Am J Roentgenol. 169(1):233-9, 1997
- Ohmori K et al: Vertebral slip in lumbar spondylolysis and spondylolisthesis. Long-term follow-up of 22 adult patients. J Bone Joint Surg Br. 77(5):771-3, 1995
- Ulmer JL et al: Distinction between degenerative and isthmic spondylolisthesis on sagittal MR images: importance of increased anteroposterior diameter of the spinal canal ("wide canal sign"). AJR Am J Roentgenol. 163(2):411-6, 1994
- Jinkins JR et al: Spondylolysis, spondylolisthesis, and associated nerve root entrapment in the lumbosacral spine: MR evaluation. AJR Am J Roentgenol. 159(4):799-803, 1992
- Reynolds R: Spondylolysis and Spondylolisthesis. Seminars in Spine Surgery. 4:235-47, 1992
- Danielson BI et al: Radiologic progression of isthmic lumbar spondylolisthesis in young patients. Spine. 16(4):422-5, 1991
- Frennered AK et al: Natural history of symptomatic isthmic low-grade spondylolisthesis in children and adolescents: a seven-year follow-up study. J Pediatr Orthop. 11(2):209-13, 1991
- Rossi F et al: Lumbar spondylolysis: occurrence in competitive athletes. Updated achievements in a series of 390 cases. J Sports Med Phys Fitness. 30(4):450-2, 1990
- Johnson DW et al: MR imaging of the pars interarticularis. AJR Am J Roentgenol. 152(2):327-32, 1989
- Rossi F: Spondylolysis, spondylolisthesis and sports. J Sports Med Phys Fitness. 18(4):317-40, 1978
- Wiltse LL et al: Classification of spondylolisis and spondylolisthesis. Clin Orthop. (117):23-9, 1976
- Wiltse LL: Spondylolisthesis. West J Med. 122(2):152-3, 1975
