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Exported BILATERAL PARS DEFECT - Nuclear medicine

This theory is supported by the fact that in patient populations who are confined to bed, paraplegics and cerebral palsy’s, the relative incidence of a pars defect is lower. In high activity sportsmen the incidence of a pars defect is higher ie diving, weight lifting and pole vaulting where there is repetitive hyperextention.

We (dr, PT, spouse, anterolisthesis pars defect me) attributed it to my limp

Subtype A :A fatigue fracture of the pars interarticularis. Subtype B :There is elongation of the pars interarticularis without a defect. Subtype C :Rare, due to severe hyperextention leading to acute pars fractures.

What Is the Pars Defect of the Lumbar Spine

Acute traumatic fractures only involving the pars are rare, and certain disease processes which weaken the bone such as Osteopetrosis can cause spondylolysis. The most widely used classification is described by Wiltse, Newman and Macnab. Associated with a congenital abnormality of the upper sacrum or the neural arch of L5. There is usually no defect of the pars. Subtype A :A fatigue fracture of the pars interarticularis. Subtype B :There is elongation of the pars interarticularis without a defect. Subtype C :Rare, due to severe hyperextention leading to acute pars fractures. Also known as degenerative spondylolisthesis with an intact neural arch ie non spondylolytic spondylolisthesis. This is 10 times more common at L4, and no greater than 25% anterior displacement occurs. It is rare under 50 years of age, it is 6 times more common in females over 60 years of age, 3 times more common in blacks as in whites, and is 4 times more likely if associated with a sacralized L5. The mechanisms of displacement are thought to involve arthrosis of the zygapophyseal joint, disc degeneration, and remodeling of the articular process and pars. Can occur as an acute fracture of a portion of the neural arch other than the pars interarticularis ie a hangman’s type fracture of C2.(note this type is different from the pars fracture – Isthmic subtype C) Generalised or systemic disorders may affect the neural arch of the spine and cause spondylolysis and subsequent spondylolisthesis. Some of the more common forms are Paget’s disease, metastastatic disease, and Osteopetrosis. Radiological evaluation is the definitive method of confirming the presence of spondylolysis and spondylolisthesis. A complete plain film series of the lumbar spine and sacrum are recommended, and should include the following views.

This is at the moment the most commonly proposed aetiological mechanism causing a pars defect. In an in vitro study on 28 human lumbar spines found that the pars interarticularis defect of the lumbar spine was related to hyperextention mechanical fatigue.

31-7-2015 · Aetiology

Spondylolysis is an interruption of the pars interarticularis, this can either be unilateral or bilateral. Spondylolisthesis: an anterior displacement of a vertebral body in relationship to the segment immediately below, this can occur with or without a defect in the pars interarticularis.

CT - linear lucency or defect extending through the pars interarticularis. Ocassionally, fragmentation of the pars interarticularis may be seen. Axial images will show absence of a complete bony ring at any given vertebral level.

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