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case_images: Lumbar plain radiographs of the 50-year-old male patient at his first visit to our orthopedic clinic.. Notes: (A) Anteroposterior and lateral films showed bilateral defects of the pars interarticularis with grade I spondylolisthesis at L5, and SBO at L5 and S1 with isolated spinous processes. (B) Double-oblique films demonstrated bilateral spondylolysis with irregular hardened edge formation. (C) Flexion-extension films revealed no segmental instability. Arrows indicate spondylolysis. Arrowheads indicate SBO.. Abbreviation: SBO, spina bifida occulta.
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case_images: Plain films showed bilateral defects of the pars interarticularis at L5 accompanied by grade I spondylolisthesis, and spina bifida occulta (SBO) at L5 and S1 with isolated spinous processes (Figure 1).
case_images: CT scans and sagittal two-dimensional reconstruction of the 50-year-old male patient at his first visit to our orthopedic clinic.. Note: Bilateral isthmic defects with sclerotic change at L5.. Abbreviation: CT, computed tomography.
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case_images: CT sagittal two-dimensional reconstruction and transverse section showed the sclerotic change in the defects of the pars interarticularis at L5 (Figure 2).
case_images: MRI of the 50-year-old male patient at his first visit to our hospital.. Notes: Low intensities in the bilateral defects of the pars interarticularis at L5 and no nerve compression or canal stenosis at the level of L5-S1. Arrows indicate spondylolysis.. Abbreviations: MRI, magnetic resonance imaging; T2WI, T2-weighted image; T1WI, T1-weighted image; STIR, short tau inversion recovery.
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case_images: Besides, the degenerative degree of L5-S1 intervertebral disc (IVD) was evaluated at Pfirrmann III (Figure 3).
case_images: The repeated lumbar radiographs after five-year follow-up.. Notes: (A) Double-oblique views demonstrated the defects of the pars were replaced by trabeculation but still left some sclerotic remnants. (B) Dynamic films demonstrated no progressive instability of the lumbar spine. Arrows indicate the bony healing of the defects of the pars interarticularis.
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case_images: After 5 years, his BMI decreased slightly to 23.2 (kg/m2), the radiographic re-examination showed the gap between the separated parts had disappeared and had been replaced by trabeculation while the healed isthmus became elongated (Figure 4).
case_images: The repeated CT scanning and sagittal two-dimensional reconstruction after 5-year follow-up.. Note: Most of the defects of the isthmus at L5 had satisfactory bony healing and the healed parts of the pars became elongated and narrow, but left a little non-union at the right-hand side.. Abbreviation: CT, computed tomography.
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case_images: Furthermore, repeated CT images confirmed the satisfying bony union of the bilateral defects without progressive spondylolisthesis (Figure 5).