Two types of laminolysis in adolescent athletes

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• 作者：Ryo Miyagi (1) (3)
  Koichi Sairyo (4)
  Toshinori Sakai (2) (3)
  Hiroshi Yoshioka (1)
  Natsuo Yasui (3)
  Akira Dezawa (4)
  
• 关键词：Laminolysis ; Spondylolysis ; Retroisthmic cleft ; Lumbar spine ; Laminar fracture ; Stress fracture
• 刊名：Journal of Orthopaedics and Traumatology
• 出版年：2012
• 出版时间：December 2012
• 年：2012
• 卷：13
• 期：4
• 页码：225-228
• 全文大小：405KB
• 参考文献：1. Sairyo K, Katoh S, Sakamaki T, Komatsubara S, Endo K, Yasui N (2003) Three successive stress fractures at the same level in an adolescent baseball player. Am J Sports Med 31:606-10
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  4. Sakai T, Sairyo K, Takao S, Nishitani H, Yasui N (2009) Incidence of lumbar spondylolysis in the general population in Japan based on multidetector computed tomography scans from two thousand subjects. Spine (Phil Pa 1976) 34:2346-350 CrossRef
  5. Sairyo K, Katoh S, Sasa T, Yasui N, Goel VK, Vadapalli S et al (2005) Athletes with unilateral spondylolysis are at risk of stress fracture at the contralateral pedicle and pars interarticularis: a clinical and biomechanical study. Am J Sports Med 33(4):583-90 CrossRef
  6. Sakai T, Sairyo K, Takao S, Kosaka H, Yasui N (2010) Adolescents with symptomatic laminolysis: report of two cases. J Orthop Traumatol 11(3):189-93 CrossRef
  7. Sairyo K, Goel VK, Vadapalli S, Vishnubhotla SL, Biyani A, Ebraheim N et al (2006) Biomechanical comparison of lumbar spine with or without spina bifida occulta. A finite element analysis. Spinal Cord 44(7):440-44
  8. Micheli LJ, Wood R (1995) Back pain in young athletes. Significant differences from adults in causes and patterns. Arch Pediatr Adolesc Med 149(1):15-8 CrossRef
  9. Johansen JG, Hemminghytt S, Haughton VM (1984) CT appearance of the retroisthmic cleft. AJNR 5:835-36
  10. Sairyo K, Katoh S, Komatsubara S, Terai T, Yasui N, Goel VK et al (2005) Spondylolysis fracture angle in children and adolescents on CT indicates the facture producing force vector: a biomechanical rationale. Internet J Spine Surg. http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijss/vol1n2/sponylolysis.xml
  
• 作者单位：Ryo Miyagi (1) (3)
  Koichi Sairyo (4)
  Toshinori Sakai (2) (3)
  Hiroshi Yoshioka (1)
  Natsuo Yasui (3)
  Akira Dezawa (4)
  
  1. Department of Radiological Sciences, University of California, Irvine, CA, USA
  3. Department of Orthopedics, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
  4. Department of Orthopaedic Surgery, School of Medicine, Teikyo University, Mizonokuchi Hospital, 3-8-3 Mizonokuchi, Takatsu-ku, Kawasaki, 213-8507, Japan
  2. Department of Orthopedic Surgery, University of California, Irvine, CA, USA
  
• ISSN：1590-9999

文摘

Bony defects in the spine are divided into three main types: spondylolysis, pediculolysis, and laminolysis. Lumbar spondylolysis is a well-known stress fracture that occurs frequently in adolescent athletes. Pediculolysis means stress fracture of the pedicle, which sometimes occurs subsequent to unilateral spondylolysis. Laminolysis is a rarely reported stress fracture similar to spondylolysis and pediculolysis that sometimes causes low back pain (LBP). However, its pathomechanism has not been elucidated. Recently, we encountered four adolescent athletes with symptomatic laminolysis. Mean age was 15.8 (range 15-7) years. All subjects reported severe LBP exacerbated by extension of the lumbar spine, and radiology revealed two types of laminolysis: hemilaminar type and intralaminar type. To elucidate the mechanisms of each type, we reviewed a biomechanical study, and found that the hemilaminar type was thought to be subsequent to contralateral spondylolysis, while the intralaminar type might be a result of a stress fracture due to repetitive extension loading.