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Pars Interarticularis Injury Differential Diagnoses

  • Author: Gerard A Malanga, MD; Chief Editor: Craig C Young, MD  more...
Updated: Oct 20, 2015
Contributor Information and Disclosures

Gerard A Malanga, MD Founder and Partner, New Jersey Sports Medicine, LLC and New Jersey Regenerative Institute; Director of Research, Atlantic Health; Clinical Professor, Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey-New Jersey Medical School; Fellow, American College of Sports Medicine

Gerard A Malanga, MD is a member of the following medical societies: Alpha Omega Alpha, American Institute of Ultrasound in Medicine, North American Spine Society, International Spine Intervention Society, American Academy of Physical Medicine and Rehabilitation, American College of Sports Medicine

Disclosure: Received honoraria from Cephalon for speaking and teaching; Received honoraria from Endo for speaking and teaching; Received honoraria from Genzyme for speaking and teaching; Received honoraria from Prostakan for speaking and teaching; Received consulting fee from Pfizer for speaking and teaching.


Nancy Kim, MD Staff Physician, Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey

Nancy Kim, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, Association of Academic Physiatrists

Disclosure: Nothing to disclose.

Chris Perez, MD Staff Physician, Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey

Chris Perez, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Medical Association

Disclosure: Nothing to disclose.

David L Tung, MD, MPH Medical Director, PainCare Ambulatory Surgical Center

David L Tung, MD, MPH is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, North American Spine Society, International Spine Intervention Society, North American Neuromodulation Society

Disclosure: Received honoraria from Purdue Pharmaceutical for speaking and teaching; Received honoraria from Endo Pharmaceutical for speaking and teaching.

Michael Goldin, MD Department of Physical Medicine and Rehabilitation, Washington Township Medical Foundation

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Henry T Goitz, MD Academic Chair and Associate Director, Detroit Medical Center Sports Medicine Institute; Director, Education, Research, and Injury Prevention Center; Co-Director, Orthopaedic Sports Medicine Fellowship

Henry T Goitz, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine

Disclosure: Nothing to disclose.

Chief Editor

Craig C Young, MD Professor, Departments of Orthopedic Surgery and Community and Family Medicine, Medical Director of Sports Medicine, Medical College of Wisconsin

Craig C Young, MD is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, American Medical Society for Sports Medicine, Phi Beta Kappa

Disclosure: Nothing to disclose.

Additional Contributors

Andrew L Sherman, MD, MS Associate Professor of Clinical Rehabilitation Medicine, Vice Chairman, Chief of Spine and Musculoskeletal Services, Program Director, SCI Fellowship and PMR Residency Programs, Department of Rehabilitation Medicine, University of Miami, Leonard A Miller School of Medicine

Andrew L Sherman, MD, MS is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, American Medical Association, Association of Academic Physiatrists

Disclosure: Nothing to disclose.

  1. Debnath UK, Freeman BJ, Grevitt MP, et al. Clinical outcome of symptomatic unilateral stress injuries of the lumbar pars interarticularis. Spine. 2007 Apr 20. 32(9):995-1000. [Medline].

  2. Olsen TL, Anderson RL, Dearwater SR, Kriska AM, Cauley JA, Aaron DJ, et al. The epidemiology of low back pain in an adolescent population. Am J Public Health. 1992 Apr. 82(4):606-8. [Medline]. [Full Text].

  3. Garry JP, McShane J. Lumbar spondylolysis in adolescent athletes. J Fam Pract. 1998 Aug. 47(2):145-9. [Medline].

  4. Hu SS, Tribus CB, Diab M, Ghanayem AJ. Spondylolisthesis and spondylolysis. Instr Course Lect. 2008. 57:431-45. [Medline].

  5. Standaert CJ, Herring SA. Spondylolysis: a critical review. Br J Sports Med. 2000 Dec. 34(6):415-22. [Medline].

  6. Wu SS, Lee CH, Chen PQ. Operative repair of symptomatic spondylolysis following a positive response to diagnostic pars injection. J Spinal Disord. 1999 Feb. 12(1):10-6. [Medline].

  7. Roche MA, Rowe GG. The incidence of separate neural arch and coincident bone variations: A survey of 4200 skeletons. Anat Rec. 1951. 109:233-52.

  8. Eisenstein S. Spondylolysis. A skeletal investigation of two population groups. J Bone Joint Surg Br. 1978 Nov. 60-B(4):488-94. [Medline]. [Full Text].

  9. Beutler WJ, Fredrickson BE, Murtland A, et al. The natural history of spondylolysis and spondylolisthesis: 45-year follow-up evaluation. Spine. 2003 May 15. 28(10):1027-35; discussion 1035. [Medline].

  10. Micheli LJ, Wood R. Back pain in young athletes. Significant differences from adults in causes and patterns. Arch Pediatr Adolesc Med. 1995 Jan. 149(1):15-8. [Medline].

  11. Morita T, Ikata T, Katoh S, Miyake R. Lumbar spondylolysis in children and adolescents. J Bone Joint Surg Br. 1995 Jul. 77(4):620-5. [Medline]. [Full Text].

  12. Duggleby T, Kumar S. Epidemiology of juvenile low back pain: a review. Disabil Rehabil. 1997 Dec. 19(12):505-12. [Medline].

  13. Fredrickson BE, Baker D, McHolick WJ, Yuan HA, Lubicky JP. The natural history of spondylolysis and spondylolisthesis. J Bone Joint Surg Am. 1984 Jun. 66(5):699-707. [Medline]. [Full Text].

  14. Wiltse LL. The etiology of spondylolisthesis. J Bone Joint Surg Am. 1962 Apr. 44-A:539-60. [Medline]. [Full Text].

  15. Bell DF, Ehrlich MG, Zaleske DJ. Brace treatment for symptomatic spondylolisthesis. Clin Orthop Relat Res. 1988 Nov. 236:192-8. [Medline].

  16. Hoshina H. Spondylolysis in athletes. Phys Sportsmed. 1980. 8(9):75-9.

  17. Ogilvie JW, Sherman J. Spondylolysis in Scheuermann's disease. Spine. 1987 Apr. 12(3):251-3. [Medline].

  18. Saraste H. Long-term clinical and radiological follow-up of spondylolysis and spondylolisthesis. J Pediatr Orthop. 1987 Nov-Dec. 7(6):631-8. [Medline].

  19. Wiltse LL, Newman PH, Macnab I. Classification of spondylolysis and spondylolisthesis. Clin Orthop Relat Res. 1976 Jun. 117:23-9. [Medline].

  20. Leone A, Cianfoni A, Cerase A, Magarelli N, Bonomo L. Lumbar spondylolysis: a review. Skeletal Radiol. 2011 Jun. 40(6):683-700. [Medline].

  21. Zehnder SW, Ward CV, Crow AJ, Alander D, Latimer B. Radiographic assessment of lumbar facet distance spacing and pediatric spondylolysis. Spine (Phila Pa 1976). 2009 Feb 1. 34(3):285-90. [Medline].

  22. Ward CV, Latimer B, Alander DH, Parker J, Ronan JA, Holden AD, et al. Radiographic assessment of lumbar facet distance spacing and spondylolysis. Spine (Phila Pa 1976). 2007 Jan 15. 32(2):E85-8. [Medline].

  23. Smith JA, Hu SS. Management of spondylolysis and spondylolisthesis in the pediatric and adolescent population. Orthop Clin North Am. 1999 Jul. 30(3):487-99, ix. [Medline].

  24. Blanda J, Bethem D, Moats W, Lew M. Defects of pars interarticularis in athletes: a protocol for nonoperative treatment. J Spinal Disord. 1993 Oct. 6(5):406-11. [Medline].

  25. Phalen G, Dickson J. Spondylolisthesis and tight hamstrings. J Bone Joint Surg Am. 1961. 43:505-12. [Full Text].

  26. Wiltse LL, Widell EH Jr, Jackson DW. Fatigue fracture: the basic lesion is inthmic spondylolisthesis. J Bone Joint Surg Am. 1975 Jan. 57(1):17-22. [Medline]. [Full Text].

  27. Rosenberg NJ, Bargar WL, Friedman B. The incidence of spondylolysis and spondylolisthesis in nonambulatory patients. Spine. 1981 Jan-Feb. 6(1):35-8. [Medline].

  28. Dietrich M, Kurowski P. The importance of mechanical factors in the etiology of spondylolysis. A model analysis of loads and stresses in human lumbar spine. Spine. 1985 Jul-Aug. 10(6):532-42. [Medline].

  29. Cyron BM, Hutton WC. The fatigue strength of the lumbar neural arch in spondylolysis. J Bone Joint Surg Br. 1978 May. 60-B(2):234-8. [Medline]. [Full Text].

  30. Gregory PL, Batt ME, Kerslake RW, Scammell BE, Webb JF. The value of combining single photon emission computerised tomography and computerised tomography in the investigation of spondylolysis. Eur Spine J. 2004 Oct. 13(6):503-9. [Medline].

  31. Green TP, Allvey JC, Adams MA. Spondylolysis. Bending of the inferior articular processes of lumbar vertebrae during simulated spinal movements. Spine. 1994 Dec 1. 19(23):2683-91. [Medline].

  32. Letts M, Smallman T, Afanasiev R, Gouw G. Fracture of the pars interarticularis in adolescent athletes: a clinical-biomechanical analysis. J Pediatr Orthop. 1986 Jan-Feb. 6(1):40-6. [Medline].

  33. Edelson JG, Nathan H. Nerve root compression in spondylolysis and spondylolisthesis. J Bone Joint Surg Br. 1986 Aug. 68(4):596-9. [Medline]. [Full Text].

  34. Eisenstein SM, Ashton IK, Roberts S, et al. Innervation of the spondylolysis "ligament". Spine. 1994 Apr 15. 19(8):912-6. [Medline].

  35. Nordstrom D, Santavirta S, Seitsalo S, et al. Symptomatic lumbar spondylolysis. Neuroimmunologic studies. Spine. 1994 Dec 15. 19(24):2752-8. [Medline].

  36. Hasegawa S, Yamamoto H, Morisawa Y, Michinaka Y. A study of mechanoreceptors in fibrocartilage masses in the defect of pars interarticularis. J Orthop Sci. 1999. 4(6):413-20. [Medline].

  37. Aland C, Rineberg BA, Malberg M, Fried SH. Fracture of the pedicle of the fourth lumbar vertebra associated with contralateral spondylolysis. Report of a case. J Bone Joint Surg Am. 1986 Dec. 68(9):1454-5. [Medline]. [Full Text].

  38. Pierce ME. Spondylolysis: what does this mean? A review. Australas Radiol. 1987 Nov. 31(4):391-4. [Medline].

  39. Amato M, Totty WG, Gilula LA. Spondylolysis of the lumbar spine: demonstration of defects and laminal fragmentation. Radiology. 1984 Dec. 153(3):627-9. [Medline]. [Full Text].

  40. Lowe J, Schachner E, Hirschberg E, Shapiro Y, Libson E. Significance of bone scintigraphy in symptomatic spondylolysis. Spine. 1984 Sep. 9(6):653-5. [Medline].

  41. Bodner RJ, Heyman S, Drummond DS, Gregg JR. The use of single photon emission computed tomography (SPECT) in the diagnosis of low-back pain in young patients. Spine. 1988 Oct. 13(10):1155-60. [Medline].

  42. Bellah RD, Summerville DA, Treves ST, Micheli LJ. Low-back pain in adolescent athletes: detection of stress injury to the pars interarticularis with SPECT. Radiology. 1991 Aug. 180(2):509-12. [Medline]. [Full Text].

  43. Itoh K, Hashimoto T, Shigenobu K, Yamane S, Tamaki N. Bone SPET of symptomatic lumbar spondylolysis. Nucl Med Commun. 1996 May. 17(5):389-96. [Medline].

  44. Herring SA, Standaert CJ. The spine in sports: re-evaluating the diagnostic assessment and treatment of spondylolysis in the young athlete. SpineLine. 2001. 1:16-20.

  45. Dutton JA, Hughes SP, Peters AM. SPECT in the management of patients with back pain and spondylolysis. Clin Nucl Med. 2000 Feb. 25(2):93-6. [Medline].

  46. Harvey CJ, Richenberg JL, Saifuddin A, Wolman RL. The radiological investigation of lumbar spondylolysis. Clin Radiol. 1998 Oct. 53(10):723-8. [Medline].

  47. Congeni J, McCulloch J, Swanson K. Lumbar spondylolysis. A study of natural progression in athletes. Am J Sports Med. 1997 Mar-Apr. 25(2):248-53. [Medline].

  48. Yamane T, Yoshida T, Mimatsu K. Early diagnosis of lumbar spondylolysis by MRI. J Bone Joint Surg Br. 1993 Sep. 75(5):764-8. [Medline]. [Full Text].

  49. Goda Y, Sakai T, Sakamaki T, Takata Y, Higashino K, Sairyo K. Analysis of MRI signal changes in the adjacent pedicle of adolescent patients with fresh lumbar spondylolysis. Eur Spine J. 2014 Sep. 23(9):1892-5. [Medline].

  50. Kobayashi A, Kobayashi T, Kato K, Higuchi H, Takagishi K. Diagnosis of radiographically occult lumbar spondylolysis in young athletes by magnetic resonance imaging. Am J Sports Med. 2013 Jan. 41(1):169-76. [Medline].

  51. Maurer M, Soder RB, Baldisserotto M. Spine abnormalities depicted by magnetic resonance imaging in adolescent rowers. Am J Sports Med. 2011 Feb. 39(2):392-7. [Medline].

  52. King HA. Back pain in children. Orthop Clin North Am. 1999 Jul. 30(3):467-74, ix. [Medline].

  53. Seitsalo S, Osterman K, Hyvãrinen H, et al. Progression of spondylolisthesis in children and adolescents. A long-term follow-up of 272 patients. Spine. 1991 Apr. 16(4):417-21. [Medline].

  54. Steiner ME, Micheli LJ. Treatment of symptomatic spondylolysis and spondylolisthesis with the modified Boston brace. Spine. 1985 Dec. 10(10):937-43. [Medline].

  55. Ikata T, Miyake R, Katoh S, Morita T, Murase M. Pathogenesis of sports-related spondylolisthesis in adolescents. Radiographic and magnetic resonance imaging study. Am J Sports Med. 1996 Jan-Feb. 24(1):94-8. [Medline].

  56. Pizzutillo PD, Hummer CD 3rd. Nonoperative treatment for painful adolescent spondylolysis or spondylolisthesis. J Pediatr Orthop. 1989 Sep-Oct. 9(5):538-40. [Medline].

  57. Pettine KA, Salib RM, Walker SG. External electrical stimulation and bracing for treatment of spondylolysis. A case report. Spine. 1993 Mar 15. 18(4):436-9. [Medline].

  58. Micheli LJ, Hall JE, Miller ME. Use of modified Boston brace for back injuries in athletes. Am J Sports Med. 1980 Sep-Oct. 8(5):351-6. [Medline].

  59. Jackson DW, Wiltse LL, Dingeman RD, Hayes M. Stress reactions involving the pars interarticularis in young athletes. Am J Sports Med. 1981 Sep-Oct. 9(5):304-12. [Medline].

  60. Axelsson P, Johnsson R, Strömqvist B. Effect of lumbar orthosis on intervertebral mobility. A roentgen stereophotogrammetric analysis. Spine. 1992 Jun. 17(6):678-81. [Medline].

  61. Lantz SA, Schultz AB. Lumbar spine orthosis wearing. I. Restriction of gross body motions. Spine. 1986 Oct. 11(8):834-7. [Medline].

  62. Willems PC, Nienhuis B, Sietsma M, van der Schaaf DB, Pavlov PW. The effect of a plaster cast on lumbosacral joint motion. An in vivo assessment with precision motion analysis system. Spine. 1997 Jun 1. 22(11):1229-34. [Medline].

  63. Sairyo K, Sakai T, Yasui N, Dezawa A. Conservative treatment for pediatric lumbar spondylolysis to achieve bone healing using a hard brace: what type and how long?: Clinical article. J Neurosurg Spine. 2012 Jun. 16(6):610-4. [Medline].

  64. Miller SF, Congeni J, Swanson K. Long-term functional and anatomical follow-up of early detected spondylolysis in young athletes. Am J Sports Med. 2004 Jun. 32(4):928-33. [Medline].

  65. Ciullo JV, Jackson DW. Pars interarticularis stress reaction, spondylolysis, and spondylolisthesis in gymnasts. Clin Sports Med. 1985 Jan. 4(1):95-110. [Medline].

  66. Sairyo K, Sakai T, Yasui N. Minimally invasive technique for direct repair of pars interarticularis defects in adults using a percutaneous pedicle screw and hook-rod system. J Neurosurg Spine. 2009 May. 10(5):492-5. [Medline].

  67. Gillis CC, Eichholz K, Thoman WJ, Fessler RG. A minimally invasive approach to defects of the pars interarticularis: Restoring function in competitive athletes. Clin Neurol Neurosurg. 2015 Aug 28. 139:29-34. [Medline].

  68. Stasinopoulos D. Treatment of spondylolysis with external electrical stimulation in young athletes: a critical literature review. Br J Sports Med. 2004 Jun. 38(3):352-4. [Medline]. [Full Text].

  69. Kaul MP, Herring SA. Rehabilitation of lumbar spine injuries in sports. Phys Med Rehabil Clin N Am. 1994. 5(1):133-56.

  70. Hald RD. Dance injuries. Prim Care. 1992 Jun. 19(2):393-411. [Medline].

  71. Steele VA, White JA. Injury prediction in female gymnasts. Br J Sports Med. 1986 Mar. 20(1):31-3. [Medline]. [Full Text].

  72. Nadler SF, Malanga GA, DePrince M, Stitik TP, Feinberg JH. The relationship between lower extremity injury, low back pain, and hip muscle strength in male and female collegiate athletes. Clin J Sport Med. 2000 Apr. 10(2):89-97. [Medline].

  73. Nadler SF, Wu KD, Galski T, Feinberg JH. Low back pain in college athletes. A prospective study correlating lower extremity overuse or acquired ligamentous laxity with low back pain. Spine. 1998 Apr 1. 23(7):828-33. [Medline].

  74. Hollinshead WH, Rosse C. Lower limb. Textbook of Anatomy. 4th ed. Philadelphia, Pa: Lippincott-Raven; 1986. 678-81.

  75. Basmajian JV, DeLuca CJ. Lower limb. Basmajian JV, DeLuca CJ, eds. Muscles Alive: Their Functions Revealed by Electromyography. 5th ed. Baltimore, Md: Lippincott Williams & Wilkins; 1985. 310-5.

  76. Kujala UM, Salminen JJ, Taimela S, Oksanen A, Jaakkola L. Subject characteristics and low back pain in young athletes and nonathletes. Med Sci Sports Exerc. 1992 Jun. 24(6):627-32. [Medline].

  77. Hoch AZ. The female athlete: what’s new? Presented at: Annual Meeting of the American Academy of Pediatrics; 2001; San Francisco, Calif.

  78. Omey ML, Micheli LJ, Gerbino PG 2nd. Idiopathic scoliosis and spondylolysis in the female athlete. Tips for treatment. Clin Orthop Relat Res. 2000 Mar. 372:74-84. [Medline].

  79. Dubousset J. Treatment of spondylolysis and spondylolisthesis in children and adolescents. Clin Orthop Relat Res. 1997 Apr. 337:77-85. [Medline].

  80. Pedersen AK, Hagen R. Spondylolysis and spondylolisthesis. Treatment by internal fixation and bone-grafting of the defect. J Bone Joint Surg Am. 1988 Jan. 70(1):15-24. [Medline]. [Full Text].

  81. Roca J, Moretta D, Fuster S, Roca A. Direct repair of spondylolysis. Clin Orthop Relat Res. 1989 Sep. 246:86-91. [Medline].

  82. Morscher E, Gerber B, Fasel J. Surgical treatment of spondylolisthesis by bone grafting and direct stabilization of spondylolysis by means of a hook screw. Arch Orthop Trauma Surg. 1984. 103(3):175-8. [Medline].

  83. Newton PO, Johnston CE 2nd. Analysis and treatment of poor outcomes following in situ arthrodesis in adolescent spondylolisthesis. J Pediatr Orthop. 1997 Nov-Dec. 17(6):754-61. [Medline].

  84. Wiltse LL, Jackson DW. Treatment of spondylolisthesis and spondylolysis in children. Clin Orthop Relat Res. 1976 Jun. 117:92-100. [Medline].

  85. Szypryt EP, Twining P, Mulholland RC, Worthington BS. The prevalence of disc degeneration associated with neural arch defects of the lumbar spine assessed by magnetic resonance imaging. Spine. 1989 Sep. 14(9):977-81. [Medline].

  86. Schlegel JD, Smith JA, Schleusener RL. Lumbar motion segment pathology adjacent to thoracolumbar, lumbar, and lumbosacral fusions. Spine. 1996 Apr 15. 21(8):970-81. [Medline].

  87. Anderson SJ. Assessment and management of the pediatric and adolescent patient with low back pain. Phys Med Rehabil Clin N Am. 1991. 2:157-85.

  88. Blackburne JS, Velikas EP. Spondylolisthesis in children and adolescents. J Bone Joint Surg Br. 1977 Nov. 59-B(4):490-4. [Medline]. [Full Text].

  89. Cyron BM, Hutton WC. Variations in the amount and distribution of cortical bone across the partes interarticulares of L5. A predisposing factor in spondylolysis?. Spine. 1979 Mar-Apr. 4(2):163-7. [Medline].

  90. Dunn AJ, Campbell RS, Mayor PE, Rees D. Radiological findings and healing patterns of incomplete stress fractures of the pars interarticularis. Skeletal Radiol. 2008 May. 37(5):443-50. [Medline].

  91. Elliott S, Hutson MA, Wastie ML. Bone scintigraphy in the assessment of spondylolysis in patients attending a sports injury clinic. Clin Radiol. 1988 May. 39(3):269-72. [Medline].

  92. Hambly MF, Wiltse LL, Peek RD. Spondylolisthesis. Williams L, Lin P, eds. The Spine in Sports. St. Louis, Mo: Mosby; 1996. 157-63.

  93. Ivanov AA, Faizan A, Ebraheim NA, Yeasting R, Goel VK. The effect of removing the lateral part of the pars interarticularis on stress distribution at the neural arch in lumbar foraminal microdecompression at L3-L4 and L4-L5: anatomic and finite element investigations. Spine. 2007 Oct 15. 32(22):2462-6. [Medline].

  94. Kurd MF, Patel D, Norton R, Picetti G, Friel B, Vaccaro AR. Nonoperative treatment of symptomatic spondylolysis. J Spinal Disord Tech. 2007 Dec. 20(8):560-4. [Medline].

  95. Libson E, Bloom RA, Dinari G. Symptomatic and asymptomatic spondylolysis and spondylolisthesis in young adults. Int Orthop. 1982. 6(4):259-61. [Medline].

  96. Muschik M, Hahnel H, Robinson PN, Perka C, Muschik C. Competitive sports and the progression of spondylolisthesis. J Pediatr Orthop. 1996 May-Jun. 16(3):364-9. [Medline].

  97. Raby N, Mathews S. Symptomatic spondylolysis: correlation of CT and SPECT with clinical outcome. Clin Radiol. 1993 Aug. 48(2):97-9. [Medline].

  98. Rossi F. Spondylolysis, spondylolisthesis and sports. J Sports Med Phys Fitness. 1978 Dec. 18(4):317-40. [Medline].

  99. Sairyo K, Katoh S, Takata Y, Terai T, Yasui N, Goel VK, et al. MRI signal changes of the pedicle as an indicator for early diagnosis of spondylolysis in children and adolescents: a clinical and biomechanical study. Spine (Phila Pa 1976). 2006 Jan 15. 31(2):206-11. [Medline].

  100. Sairyo K, Sakai T, Yasui N. Conservative treatment of lumbar spondylolysis in childhood and adolescence: the radiological signs which predict healing. J Bone Joint Surg Br. 2009 Feb. 91(2):206-9. [Medline].

  101. Soler T, Calderon C. The prevalence of spondylolysis in the Spanish elite athlete. Am J Sports Med. 2000 Jan-Feb. 28(1):57-62. [Medline].

  102. Stewart TD. The age incidence of neural-arch defects in Alaskan natives, considered from the standpoint of etiology. J Bone Joint Surg Am. 1953 Oct. 35-A(4):937-50. [Medline]. [Full Text].

Table 1. Outline of the Treatment Strategy Based on Results of Plain Radiographs and SPECT Scanning in the Evaluation of Defects of the Pars Interarticularis in Patients Clinically Suspected of Having Symptomatic Pars Interarticularis Lesions
Plain RadiographSPECT ScanInterpretationManagement
NegativeNegativePathology other than pars defect should be suspectedFurther investigation of cause of back pain should be performed (eg, MRI)
NegativePositiveEarly pars interarticularis fractureConservative management in form of rest, +/– bracing
PositiveHealingSpondylolysisConservative management in the form of rest and bracing
PositiveNegativePseudoarthrosis or old unhealed fractureConsider surgical intervention for stabilization to prevent spondylolisthesis and to relieve pain. Consider further investigation to rule out alternative pathology.
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