![]() ![]() A SPECT scn uses a small amount of radioactive material to identify areas of increased bone activity. Single Photo Emission Computed Tomography (SPECT) scans. In some cases, a spondylolysis may be discovered in the spine of some teenagers and children when they undergo a CT scan for unrelated reasons, such as abdominal pain or after an accident. Because there is more radiation exposure with CT scans than with regular X-rays, however, your child's doctor may not routinely order this test. CT scans can help your child's doctor learn more about the fracture or slippage and can be helpful in planning treatment. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010.Ĭomputed Tomography (CT) Scans. Computed tomography combines X-ray with computer technology to produce more detailed images than plain X-rays. Reproduced from JF Sarwark, ed: Essentials of Musculoskeletal Care, ed 4. If x-rays show a crack or stress fracture in the pars interarticularis portion of the fourth or fifth lumbar vertebra, it is an indication of spondylolysis. The doctor may order X-rays of your child's lower back from a number of different angles to look for a stress fracture and to view the alignment of the vertebrae. X-rays provide images of dense structures, such as bone. Imaging tests will help confirm the diagnosis of spondylolysis or spondylolisthesis. In some cases, tight hamstrings may cause a patient to stand awkwardly or walk with a stiff-legged gait. The doctor will also observe your child's posture and gait (the way they walk). Your child's doctor will carefully examine your child's back and spine, looking for: Children who participate in sports that place excessive stress on the lower back are more likely to have a diagnosis of spondylolysis or spondylolisthesis. They will want to know if your child participates in sports. Your child's doctor will begin by taking a medical history and asking about your child's general health and symptoms. Patients with high-grade slips are more likely to experience significant pain and nerve injury and to need surgery to relieve their symptoms and prevent further deterioration. A high-grade slip occurs when more than 50% of the width of the fractured vertebra slips forward on the vertebra below it. In children and adolescents, this slippage most often occurs during periods of rapid growth - such as an adolescent growth spurt.ĭoctors commonly describe spondylolisthesis as either low grade or high grade, depending upon the amount of slippage. In spondylolisthesis, the fractured pars interarticularis separates, allowing the injured vertebra to shift or slip forward on the vertebra directly below it. Often, patients with spondylolysis will also have some degree of spondylolisthesis. Spondylolysis can occur in people of all ages without injury or sports participation. For this reason, it is the area most vulnerable to injury from the repetitive stress and overuse that characterize many sports. The pars interarticularis is the weakest portion of the vertebra. Fracture can occur on one side or both sides of the bone. Most commonly, this fracture occurs in the fifth vertebra of the lumbar spine, although it sometimes occurs in the fourth lumbar vertebra. The pars interarticularis is a small, thin portion of the vertebra that connects the upper and lower facet joints. In spondylolysis, a crack or stress fracture develops through the pars interarticularis (pars fracture).
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