Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jun 15;42(12):E716-E720.
doi: 10.1097/BRS.0000000000001931.

Conservative Treatment for Bony Healing in Pediatric Lumbar Spondylolysis

Toshinori Sakai  1 , Fumitake Tezuka, Kazuta Yamashita, Yoichiro Takata, Kosaku Higashino, Akihiro Nagamachi, Koichi Sairyo
Affiliations

Conservative Treatment for Bony Healing in Pediatric Lumbar Spondylolysis

Toshinori Sakai et al. Spine (Phila Pa 1976). .

Abstract

Study design: A retrospective review of prospectively collected data.

Objective: The aim of this study was to investigate recent outcomes of conservative treatment for bony healing in pediatric patients with lumbar spondylolysis (LS) and to identify the problems that need to be resolved.

Summary of background data: Several diagnostic and therapeutic techniques for LS have been developed recently, leading to better outcomes for bony healing.

Methods: Overall, 63 consecutive pediatric patients (53 boys and 10 girls) with LS (average age: 13.8 years; range: 6-17 years) were analyzed. Diagnosis and staging (very early, early, progressive, and terminal) were based on multidetector computed tomography (CT) scans and magnetic resonance imaging (MRI). For all patients except those with terminal-stage pars defect, conservative treatment included rest, avoidance of sports, and the use of a thoraco-lumbo-sacral-type trunk brace. Follow-up MRI was performed monthly. When the signal changes resolved, CT scans were obtained to assess bony healing.

Results: Three patients dropped out during the study period. A total of 60 patients were included (50 boys and 10 girls) in this study (follow-up rate: 95.2%), with 86 instances of LS (very early: 36, early: 16, progressive: 15, terminal: 19) in 65 laminae. In the very early stage, the bony healing rate was 100%, and average treatment period was 2.5 months (range: 1-7 months). In the early stage, the bony healing rate was 93.8%, and the average treatment period was 2.6 months (range: 1-6 months). In the progressive stage, the bony healing rate was 80.0%, and the average treatment period was 3.6 months (range: 3-5 months). The average overall recurrence rate was 26.1%. All patients showing recurrence eventually achieved bony healing.

Conclusion: High bony healing rates and short treatment periods were observed with conservative treatment in pediatric patients with LS. However, the recurrence rates were relatively high. This issue should be targeted in future studies.

Level of evidence: 2.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Fredrickson BE, Baker D, McHolick WJ, et al. The natural history of spondylolysis and spondylolisthesis. J Bone Joint Surg Am 1984; 66:699–707.
    1. Wiltse LL. Etiology of spondylolisthesis. Clin Orthop Relat Res 1957; 10:48–59.
    1. Wiltse LL, Widell EH Jr, Jackson DW. Fatigue fracture: the basic lesion in isthmic spondylolisthesis. J Bone Joint Surg Am 1975; 57:17–22.
    1. Sakai T, Sairyo K, Suzue N, et al. Incidence and etiology of lumbar spondylolysis: review of the literature. J Orthop Sci 2010; 15:281–288.
    1. Sakai T, Yamada H, Nakamura T, et al. Lumbar spinal disorders in patients with athetoid cerebral palsy: a clinical and biomechanical study. Spine 2006; 31:E66–E70.

LinkOut - more resources