Radiological diagnostic of lumbar spondylolysis.

Summary. Spondylolysis involves disruption of the bone structure at the vertebral arch at the isthmus. Various methods are utilized in diagnosing spondylolysis, such as plain radiography, computed tomography (CT), magnetic resonance (MR), and scintigraphy. Plain radiography with anteroposterior (A-P) and lateral views is a useful method in the initial diagnostics of low back pain. Although lateral views have great value in the assessment of the progression of slippage, dynamic views are useful for the determination of vertebral stability, while oblique views seem be less precise. There is evidence that CT has the greatest value in the diagnosis of spondylolysis and lumbar spine evaluation generally. The use of multiplanar reconstruction (MPR) and three-dimensional (3D) reconstruction have increased the reliability and value of CT examination, when only axial sections are analyzed. CT examination with MPR and 3D reconstruction enables reliable, diagnosis of spondylolysis and attendant complications, such as nucleus pulposus herniation, spondylolisthesis, and narrowing of intervertebral foramina and the vertebral canal. MR imaging is useful is assessing soft tissues, and should be utilized primarily in neurological complications. Scintigraphy does not seems to have any practical importance in evaluating spondylolysis.