case_images: PMC11697997_01
case_images: Case 1. Plain radiographs of the whole spine in a standing position.. A: preoperative AP view, B: preoperative lateral view, C: postoperative AP view, and D: postoperative lateral view. AP: anteroposterior
case_images: cureus-0017-00000076854-i01.jpg
case_images: PMC11697997_01_cureus-0017-00000076854-i01.jpg
case_images: FIG1
case_images: Plain radiographs of the standing whole spine showed a 40  structural curve from T11 to L4 (32  in left side bending position) and a 31  non-structural curve from T5 to T11 (21  in right side bending position) (Figures 1A, 1B). T11 to L4 curve had progressed to 47 , and surgery was planned (Figures 1A, 1B). The spino-pelvic parameters were the following: Pelvic incidence (PI): 65 , Pelvic tilt (PT): 19 , Sacral slope (SS): 44 , and Lumbar lordosis (LL): 55 . Nine months after diagnosis, posterior corrective fusion surgery was performed from T5 to L3 (Figures 1C, 1D).
case_images: Case 1. Sagittal and axial CT images for the PI of L4. . Preoperative and one week after surgery CT scans show no abnormalities in the pars interarticularis (PI) of L4 (A: preoperative right PI, B: preoperative left PI, C: right PI one week after surgery, and D: left PI one week after surgery). CT at the onset of low back pain, 43 months postoperatively, shows bilateral spondylolysis of L4 (E: right PI, F: left PI, and G: L4 axial). PI: pars interarticularis
case_images: cureus-0017-00000076854-i02.jpg
case_images: PMC11697997_01_cureus-0017-00000076854-i02.jpg
case_images: FIG2
case_images: PI, 18  for PT, 46  for SS, and 67  for LL, indicating augmentation of lumbar lordosis. Preoperative and one week after surgery, CT scans show no abnormalities in the pars interarticularis (PI) of L4 (Figures 2A-2D). She presented to our hospital, where CT revealed bilateral spondylolysis at the L4 (Figures 2E-2G).
case_images: PMC11697997_02
case_images: Case 2. Plain radiographs of the whole spine in a standing position.. A: preoperative AP view, B: preoperative lateral view, C: postoperative AP view, and D: postoperative lateral view.
case_images: cureus-0017-00000076854-i03.jpg
case_images: PMC11697997_02_cureus-0017-00000076854-i03.jpg
case_images: FIG3
case_images: T5 to T12 curve had progressed to 64 , and surgery was planned (Figures 3A, 3B). The spino-pelvic parameters were the following: PI: 56 , PT: 14 , SS: 42 , and LL: 46 . Ten months after diagnosis, posterior correction and fusion surgery were performed from T3 to L2 (Figures 3C, 3D).
case_images: Case 2. Pre- and postoperative sagittal and axial CT images for the PI of L3.. Preoperative and one week after surgery CT scans show no abnormalities in the PI of L3 (A: preoperative right PI, B: preoperative left PI, C: right PI one week after surgery, and D: left PI one week after surgery). At a regular check-up, 50 months postoperatively, bilateral L3 spondylolysis was observed (E: sagittal view of right PI, F: sagittal view of left PI, G: axial view of right PI, and H: axial view of left PI). PI: pars interarticularis
case_images: cureus-0017-00000076854-i04.jpg
case_images: PMC11697997_02_cureus-0017-00000076854-i04.jpg
case_images: FIG4
case_images: PI, 15  for PT, 43  for SS, and 51  for LL, indicating augmentation of lumbar lordosis. Preoperative and one week after surgery, CT scans show no abnormalities in the PI of L3 (Figures 4A-4D). CT was performed, and the patient was diagnosed with bilateral L3 end-stage spondylolysis (Figures 4E-4H).