Utility of ultrasonography in the diagnosis of lumbar spondylolysis in adolescent patients

J Orthop Sci. 2023 Sep;28(5):955-960. doi: 10.1016/j.jos.2022.06.019. Epub 2022 Jul 19.

Abstract

Background: This study aims to investigate the utility of the Doppler effect on ultrasonography for the diagnosis of very early- and early-stage lumbar spondylolysis in adolescent patients.

Methods: In total, 76 adolescent patients with acute and subacute low back pain were prospectively enrolled, with 46 having lumbar spondylolysis and the remaining 30 having low back pain without spondylolysis. MRI and/or computed tomograms scans revealed very early- and early-stage lumbar spondylolysis. Furthermore, positive Doppler findings in ultrasonography around the area from the facet joint to the laminae were investigated.

Results: There were no significant differences in age (p > 0.99) and body mass index (p = 0.11) between cases with and without spondylolysis. Very early- and early-stage spondylolysis were observed in 27.6% and 72.4% of patients, respectively. Positive power Doppler was 91.3% and 33.3% in cases with and without spondylolysis, respectively, which was significantly higher in spondylolysis (p < 0.001). The sensitivity and specificity of this positive power Doppler were 91.4% and 66.7%, respectively. Furthermore, the rate of positive power Doppler was significantly higher in early-stage spondylolysis (p = 0.02), with 75.0% and 97.6% sensitivity in very early- and early-stage spondylolysis, respectively.

Conclusions: A positive Doppler effect on ultrasonography is effective for screening very early- and early-stage spondylolysis in adolescent patients in an outpatient clinic.

Keywords: Lumbar spondylolysis; Magnetic resonance image; Power Doppler; Screening; Ultrasonography.

MeSH terms

  • Adolescent
  • Humans
  • Low Back Pain* / diagnostic imaging
  • Low Back Pain* / etiology
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbosacral Region
  • Magnetic Resonance Imaging
  • Spondylolysis* / diagnostic imaging
  • Ultrasonography