title: Multi-level spondylolysis.
abstract: The incidence of isthmic spondylolysis is approximately  3% to 6% in the general population. Spondylolytic defects  involving multiple vertebral levels, on the other hand, are  extremely rare. Only a handful of reports have examined the  outcomes of surgical treatment of multi-level spondylolysis.  Here, we present one case of bilateral pars defects at L3,  L4, and L5. The patient, a 46-year-old female, presented  with lower back pain radiating into the left lower extremity.  Radiographs and CT scans of the lumbar spine revealed  bilateral pars defects at L3-L5. The patient underwent  lumbar discectomy and interbody fusion of L4-S1 as well  as direct repair of the pars defect at L3. There were no  postoperative complications, and by seven months the  patient had improved clinically. While previous reports  describe the use of either direct repair or fusion in the  treatment of spondylolysis, we are unaware of reports  describing the use of both techniques at adjacent levels.
authors.affiliation: Department of Neurosurgery, University of Maryland Medical Center, Baltimore, Maryland, USA.
authors.forename: David S
authors.initials: DS
authors.lastname: Hersh
authors.forename: Yong H
authors.initials: YH
authors.lastname: Kim
authors.forename: Afshin
authors.initials: A
authors.lastname: Razi
mesh_terms: D000058:Accidental Falls; D001416:Back Pain / Q000209:etiology; D017586:Diskectomy; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D016059:Range of Motion, Articular; D020127:Recovery of Function; D013123:Spinal Fusion; D013169:Spondylolysis / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome