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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Stress fractures and reactions of the pubic ramus, pubic symphsitis, gracilis syndrome, pelvic avulsion injuries, femoral stress fractures, degenerative osteoarthritis, discogenic pain, and spondylolysis are among the multiple conditions causing groin pain in the athlete. These conditions occasionally have uncertain etiologies and are contributed to by poor training techniques and ill-repaired running shoes, combined with minor congenital anomalies that may have been silent prior to the demands of athletic competition. Roentgen documentation of the specific injury enables early appropriate treatment and minimal "down time".
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PMID:Roentgen examination of groin and hip pain in the athlete. 333 29

The source of pain in isthmic spondylolisthesis is uncertain. Some authors believe that spondylolysis and/or spondylolisthesis is not a predisposing factor to low back pain and that the mere presence of isthmic spondylolisthesis may, indeed, not be the cause of low back pain in the patient. This study explores a possible source of biomechanical dysfunction as an origin of pain in isthmic spondylolisthesis. One hundred and twenty lumbar intervertebral disc angles were measured, 60 of which had spondylolisthesis and the remaining 60 without spondylolisthesis for comparison of the effect that spondylolisthesis has on intervertebral disc angulation of the lumbar spine. The results reveal that the L4-L5 joint has the greatest biomechanical stress placed upon it by virtue that it had the highest intervertebral disc angulation when the component of spondylolisthesis was a factor at L5-S1. Therefore, due to increased intervertebral disc angles at L4-L5, a biomechanical stressing and resulting hyperextension of the facet articulation at L4-L5 may represent a source of symptomatology in isthmic spondylolisthesis of L5-S1.
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PMID:Foraminal encroachment syndrome in true lumbosacral spondylolisthesis: a preliminary report. 369 62

We analysed 80 consecutive patients with postero-lateral spine fusion performed during the years 1972-1976. Thirty-seven were women and 43 men, the mean age being 30 (14-54) years. In 73 cases the fusion was performed because of spondylolysis and spondylolisthesis and in seven because of some other form of painful instability. Preoperatively, all patients had pain in normal activities and 63 at rest. At the 1-5-year follow-up, eight patients were pain-free, while 69 had stress pain and 35 pain at rest. The reduction of pain was significant; 51 patients considered themselves improved, 18 unchanged and 10 worse. Twelve fusions united in less than 2 months, eight after more than 4 months, and two failed to unite. Patients under 20 years did better than older patients. The result was better when the fusion united within 4 months and also when the bone transplants were properly placed. We conclude that postero-lateral spine fusion can be advocated as treatment of painful spondylolisthesis and sometimes in low-back instability in younger patients.
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PMID:Postero-lateral spine fusion. A 1-4-year follow-up of 80 consecutive patients. 389 27

Sixty-seven persons with symptomatic spondylolysis or grade 1 spondylolisthesis were treated with the modified Boston brace. The average age was 16.0 years, and the average follow-up was 2.5 years. Following treatment, 52 persons (78%) had either an excellent or good result with no pain and returned to full activities. Nine (13%) continued to have mild symptoms, and six (9%) subsequently required fusion in situ. Twelve of the patients showed radiographic evidence of healing of their pars defect(s). This group and those with the best overall results tended to be men with spondylolysis and relatively acute onset of symptoms. Age, delay in treatment, spina bifida, and bone scan result did not correlate with the ultimate clinical result.
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PMID:Treatment of symptomatic spondylolysis and spondylolisthesis with the modified Boston brace. 391 87

Twenty selected patients with spondylolysis have been studied following apophyseal joint arthrography. In each instance a communication with the defect of the pars interarticularis was demonstrated by the extension of contrast medium from injection into the adjacent facet joint. The clinical and radiological features are described. The anatomical basis of the abnormality is presented using macroscopic and radiographic correlation from a dissected cadaveric specimen of spondylolysis. Sixty-five per cent of the patients experienced significant relief of pain symptoms when long-acting local anaesthetic was introduced into the facet joint.
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PMID:Spondylarthrography: the demonstration of spondylolysis by apophyseal joint arthrography. 406 36

Three children presented with low back pain radiating to the leg and with spasm of the hamstring and paravertebral muscles. Since the pain could not be ascribed to trauma, it was necessary to exclude the presence of infection or tumors. All the signs--localization of the pain, tenderness on one side of the back, X-ray film findings of unilateral or bilateral spondylolysis, and localized positive bone scan--pointed to spondylolysis as the cause of pain. All three children exhibited symptoms resembling those found in the facet syndrome described by Mooney and Robertson.
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PMID:Radiating leg pain and positive straight leg raising in spondylolysis in children. 622 78

A stress reaction involving the pars interarticularis of the lumbar spine was confirmed in seven young athletes with a positive technetium pyrophosphate bone scan. No pars defects were detectable on their lumbosacral roentgenograms, which included oblique views. The return to normal levels of radioactive uptake on repeat bone scans correlated closely with their clinical course. If the bony reaction is recognized early, it may heal at a subroentgenographic level and prevent the development of lumbar spondylolysis. These early lesions usually show unilateral increased uptake at one lumbar level on the bone scan and, initially, the athlete localizes the pain to the corresponding unilateral lumbar paraspinous area. The "one-legged hyperextension test" is positive on the ipsilateral side and aggravates the pain. Treatment consists of avoiding the aggravating activities and resting. The average time for return to pain-free competition was 7.3 months. These developing defects may be the source of considerable prolonged disability in the young athlete, particularly if undiagnosed and untreated.
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PMID:Stress reactions involving the pars interarticularis in young athletes. 626 44

Spondylolysis of the sixth cervical vertebra was reported in a thirty-seven-year-old man. He complained of sleeplessness and had no history of trauma. Plain cervical spine films and CT scan showed separation of the bilateral pars interarticularis and hypoplasia of the superior and inferior articular processes of C6. And they showed compensated hyperplasia and upward deviation of the right superior articular process of C7, but there was no instability of cervical vertebra. Spina bifida occulta at C6 and deviation of the spinous process of C7 to the left side were observed clearly on CT scan. We gave him no surgical treatment because of his normal neurological state and absence of instability. Cervical spondylolysis is very rare disease, so only 48 cases have been reported in literature. Our case is the first case that reports findings of CT scan. Radiographic findings and the absence of history of trauma suggest a congenital etiology of this illness. In the 49 patients including our case, 35 patients were males and 14 were females. 35 patients complained of neck and/or occipital pain, 12 of pain and/or sensory disturbance of upper extremities, and 8 of shoulder pain and/or stiffness. The prevalent site of involvement appears to be C6 with only 14 cases involving another level, C2, C3, C4 or C5. 36 patients had spina bifida occulta and it was most frequently detected at the level of C6.
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PMID:[Cervical spondylolysis--a case report and review of the literature]. 635 22

Facet joint arthrography was performed in 11 patients with lumbar spondylolysis. An abnormal communication between the two facet joints bordering the separated par interarticularis was observed in nine of these patients. This communication occurred through a channel in the area of the defect. In one patient with bilateral spondylolysis of the L5 vertebra, both left adjacent apophyseal joints were observed to communicate not only with one another, but also with the contralateral facet joints, through a transverse channel joining the isthmic areas of L5. Significant pain relief following intra-articular administration of anesthetics and corticosteroids was recorded in 5 patients, for periods lasting from 2 to 10 months. Spondylolysis considerably alters the soft tissues of the adjacent facet joints. Irritation of these structures might explain certain complaints of patients with spondylolysis.
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PMID:Facet joint arthrography in lumbar spondylolysis. 645 63

Spondylolysis is a common problem found in 5% of the general population. The etiology is a combination of two factors: (1) hereditary predisposition resulting from a congenital deficiency of the sacrum and posterior structures and (2) developmental factors, such as trauma, posture, or certain repetitive activities, that may precipitate a stress fracture of the pars interarticularis in susceptible individuals. Although the lesion occurs during the growth years, few individuals develop symptoms during childhood and adolescence. For the occasional child who develops symptoms, the onset usually coincides with the adolescent growth spurt, and similarly progression of spondylolisthesis occurs between the ages of 10 and 15. When symptoms develop, the child may complain of low back pain and to a lesser extent pain in the posterior buttock and thighs, usually without a neurologic deficit. A few seek medical attention because of the postural deformity or abnormal gait, secondary to hamstring tightness. Symptoms are usually initiated by strenuous activity and relieved by limitation of activity or rest. Children with spondylolisthesis appear to have more flexibility or looseness at the L5-S1 junction than their adult counterparts (Fig. 7-11). This increased mobility is reflected in the radiologic appearance of the vertebrae. There is gradual erosion of the anterior as well as the posterior aspect of the sacrum, which becomes domed or peaked in the middle. This inhibition of growth is mirrored in the trapezoid shape of the body of L5 and directly related to the degree of slip. The wear pattern suggests a teeter-totter type of instability of the fifth lumbar vertebra on the sacrum (Fig. 7-15). The sclerotic buttress appearance or reactive changes common in adults are uncommon in children (Fig. 7-17). As the slip advances to the higher grades, the sacrum and posterior aspect of the pelvis become more vertical (anterior inclination), again reflecting instability in combination with tight hamstrings and backward pulling of the pelvis (angle of tilt), giving rise to the marked physical changes and localized kyphosis of the lumbosacral spine. There is considerable evidence to suggest that when the spondylolisthesis exceeds 50%, there are many dynamic and anatomic factors at work to potentiate continued deformity and symptoms in the growing adolescent. This is reflected clinically by the frequent failure of conservative measures in controlling symptoms and the need for surgical intervention in a significant percentage of patients once the slip exceeds grade II.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Spondylolysis and spondylolisthesis in children. 654 62


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