The imaging and management of nonconsecutive pars interarticularis defects: a case report and review of literature.
BACKGROUND
Lumbar spondylolysis is a well-recognized condition occurring in adolescents because of repetitive overuse in sports. Multiple-level spondylolysis involving consecutive lower lumbar segments are rare. Several authors have reported failure of conservative treatment in the management of multiple-level pars fractures.


METHODS
A case report and review of previous literature is presented.


OBJECTIVE
The objectives of this case report were to present a rare case of pars fracture involving nonconsecutive segments and discuss image findings and treatment.


METHODS
The patent's history, clinical examination, computed tomography (CT), magnetic resonance imaging (MRI) findings, and treatment are reported. We also discuss the pathogenesis, various treatment options, and review the literature.


RESULTS
We present the fourth case of bilateral pars fractures involving nonconsecutive lower lumbar spine segments of L3 and L5, in a 16-year-old young adolescent footballer who presented with 4-month history of constant low back pain. After 1 year of conservative management, the more acute fractures at L3 showed complete bony union, symptomatic pain relief, and return to full sporting activity.


CONCLUSIONS
We report a rare case of bilateral pars fractures involving nonconsecutive segments. Multiplane reconstruction of CT images and MRI are very useful in planning treatment and follow-up. Conservative management may be used to treat multilevel nonconsecutive pars fractures.
X-ray Department, University Hospital of North Staffordshire NHS Trust, Royal Infirmary, Princes Road, Hartshill, Stoke-On-Trent, Staffordshire, United Kingdom.
Mohammed
M
Nayeemuddin
Paula J
PJ
Richards
Elnasri B
EB
Ahmed
D000293:Adolescent; D001265:Athletic Injuries / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D001915:Braces; D005081:Exercise Therapy; D017102:Fracture Healing; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D008159:Lumbar Vertebrae / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D059408:Pain Management; D020127:Recovery of Function; D012146:Rest; D016136:Spina Bifida Occulta / Q000150:complications / Q000175:diagnosis; D016103:Spinal Fractures / Q000150:complications / Q000473:pathology* / Q000628:therapy; D013169:Spondylolysis / Q000209:etiology / Q000473:pathology* / Q000628:therapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome