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Spondylolysis & Spondylolisthesis

  • caused by a defect in the pars interarticularis

  • usually a fatigue fracture from repetitive hyperextension stresses (gymnasts)

  • most common cause of LBP in adolescents

  • Radiology

    • plain x-rays demonstrate 80% of lesions

    • oblique views - additional 15% picked up - 'Scottie dog' sign (Lachapelle)

  • CT - may miss fracture

  • Bone Scan - incr. uptake indicates an acute lesion which will probably heal

  • Non-union is common

Scottie dog sign

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