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Chapter 36 

Chapter 36
Chapter:
Chapter 36
Author(s):

Cornelia Wenokor

, Remi M. Ajiboye

, and Arya N. Shamie

DOI:
10.1093/med/9780199393947.003.0036
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date: 22 October 2021

Spondylolysis defects can be unilateral or bilateral. If bilateral, there may be an associated spondylolisthesis. Unilateral spondylolysis may result in a sclerotic appearance of the contralateral pedicle; this is a stress reaction. The differential diagnosis for a sclerotic pedicle includes osteoid osteoma and metastatic disease. L4/L5 and L5/S1 are most frequently affected. Oblique radiographs or CT are helpful for diagnosis. The goals of treatment of a pars defect are aimed at alleviation of pain and facilitation of bone healing. It is usually treated conservatively with cessation of aggravating activity and spinal bracing for 3–6 months. Surgical treatment is instituted in patients who fail to respond to conservative treatment.

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