Leone, Cianfoni, Cerase, Magarelli, and Bonomo, (2011) state, “Spondylolysis is a unilateral or bilateral bony defect in the pars interarticularis (or isthmus) of the vertebra. The term derives from the Greek words spondylos (vertebra) and lysis (defect). The pars interarticularis represents the junction of the pedicle, articular facets and lamina...” (p. 683), demonstrated in the image on the left. The authors continue, “Spondylolysis can be asymptomatic or can be a cause of spine instability, back pain, and radiculopathy” (Leone et al., 2011, p. 683).
When this condition is suspected, a practitioner’s knowledge of advanced imaging is critical. “Computed tomography is the best procedure for clearly visualizing spondylolysis when a pars fracture is present” (Leone et al., 2011, p. 688).
However, if nerve root injury is also suspected, MRI is the imaging modality of choice. The authors report, “If MR imaging is used with the specific aim of diagnosing spondylolysis, each examination should include at least 3-mm sagittal and reverse angle oblique axial T1-weighted images as well as 4-mm sagittal and 3-mm reverse angle oblique axial fluid-sensitive fat suppressed sequences (i.e., short-tau inversion recovery [STIR] or fat-saturated T2-weighted images). A sagittal thin-section 3D spoiled gradient echo sequence is also a useful technique in demonstrating the integrity of the cortex of the pars” (Leone et al., 2011, p. 691).
For more information on the details of the imaging sequences and why they should be used in this situation, please contact any of the providers below for additional explanation and information.
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Leone, A., Cianfoni, A., Cerase, A., Magarelli, N., & Bonomo, L. (2011). Lumbar spondylolysis: A review. Skeletal Radiology, 40(6), 683–700.