Imaging Pediatric Spondylolysis: A Systematic Review

@article{Tofte2017ImagingPS,
  title={Imaging Pediatric Spondylolysis: A Systematic Review},
  author={Josef N Tofte and Tyler Carllee and Andrew J Holte and Sean E Sitton and Stuart L. Weinstein},
  journal={SPINE},
  year={2017},
  volume={42},
  pages={777–782}
}
Study Design. A systematic review. Objective. The aim of this study was to provide an evidence-based recommendation for when and how to employ imaging studies when diagnosing back pain thought to be caused by spondylolysis in pediatric patients. Summary of Background Data. Spondylolysis is a common structural cause of back pain in pediatric patients. The radiologic methods and algorithms used to diagnose spondylolysis are inconsistent among practitioners. Methods. A literature review was… 
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References

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Spondylolysis is frequently missed by MRI in adolescents with back pain
TLDR
In patients with a history or physical findings suggestive of spondylolysis, such as localized pain of the lumbar spine with back extension, further radiographic evaluation should be considered, even if an MRI is negative.
Use of Magnetic Resonance Imaging in the Evaluation of Spondylolysis
TLDR
MRI is an effective method (92% sensitivity) for detecting pars injuries and can detect stress reactions when a fracture is not visible on CT scan, allowing early treatment of these prelysis lesions.
Diagnosis of Radiographically Occult Lumbar Spondylolysis in Young Athletes by Magnetic Resonance Imaging
Background: The early stages of spondylolysis are extremely difficult to diagnose on plain radiography. Although several studies have examined changes in active spondylolysis on magnetic resonance
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TLDR
MRI can be used as an effective and reliable first-line image modality for diagnosis of juvenile spondylolysis, however, localised CT is recommended as a supplementary examination in selected cases as a baseline for assessment of healing and for evaluation of indeterminate cases.
Imaging Modalities for Low Back Pain in Children: A Review of Spondyloysis and Undiagnosed Mechanical Back Pain
TLDR
The goals of this study are to evaluate the value of radiographic studies in establishing a diagnosis of spondylolysis, and determine the cost and radiation effective doses (EDs) associated with those studies with the associated risks radiation exposure.
Diagnostic Modalities for the Evaluation of Pediatric Back Pain: A Prospective Study
TLDR
It is suggested that pediatric back pain frequently does not carry a definitive diagnosis and that exhaustive diagnostic protocols may not be necessary for this problem.
Is the Scotty Dog Sign Adequate for Diagnosis of Fractures in Pediatric Patients with Lumbar Spondylolysis?
TLDR
The results suggest that plain radiographic films can no longer be considered adequate for early and accurate diagnosis of LS and advanced imaging procedures, such as MRI in the early diagnosis or CT for persistent cases, are recommended.
MRI Signal Changes of the Pedicle as an Indicator for Early Diagnosis of Spondylolysis in Children and Adolescents: A Clinical and Biomechanical Study
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The correlation between the high stresses in the pedicle and the corresponding HSC suggest that signal changes in MRI could be used as an indicator for early diagnosis of spondylolysis.
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TLDR
A new classification for pediatric spondylolysis and sponylolisthesis is proposed that is comprehensive, simple, and easily applied and more appropriate for the child and adolescent than the existing classification schemes of Wiltse-Newman and Marchetti-Bartolozzi.
Analysis of MRI signal changes in the adjacent pedicle of adolescent patients with fresh lumbar spondylolysis
TLDR
MRI revealed a higher prevalence of L3 or L4 spondylolysis than observed with CT, and was used to examine the changes in spinal level signals in the pedicles adjacent to the pars interarticularis in adolescents with fresh lumbar spondyolysis.
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