Presentation
Staging scan for gastric carcinoma. No history of trauma.
Patient Data
There are bilateral L4 pars interarticularis defects with well-defined sclerotic margins, L4/5 disc degeneration and spondylolisthesis (grade 1 anterolisthesis).
Minor bilateral L4 foraminal stenosis.
Partial sacralization of the L5 vertebra.
The spine is otherwise normal.
Case Discussion
Incidental bilateral L4 spondylolysis with established non-union is most likely due to repetitive microtrauma. Sacralization of L5 makes L4/5 the most distal mobile level and predisposes to L4 spondylolysis. This reduces posterior support at this level and increases shearing forces on the L4/5 disc, causing premature disc degeneration, disc narrowing and anterolisthesis.
Co-contributor: Dr. Anwar-ul-Haq Zadran.
Unable to process the form. Check for errors and try again.