Lumbar pars injury or spondylolysis – diagnosis and management

Abstract

Lumbar pars injury or spondylolysis is a unique lesion occurring only in human beings representing a stress fracture of the pars interarticularis and occurs most commonly at L5. Symptoms of low back pain relating to this lesion are more common in young athletes involved in trunk twisting sports. Diagnosis is dependent on plain radiography, computed tomography (CT) scan and magnetic resonance imaging (MRI) scans. Unilateral pars defect are less common than bilateral defects and run a more benign course. Treatment is dependent on symptoms as well as radiographic stage of the lesion. Conservative management is the mainstay of treating early lesions. Professional sporting individuals are at increased risk of failure of resolution of symptoms that may require early operative repart of the pars defect. Modified Buck’s technique of direct repair using screws has a high success rate in patients who have persistent low back pain. Preoperative ODI and SF-36 physical component scores (PCS) are significant predictor of a good functional outcome