ID | 111239 |
Author |
Sairyo, Koichi
Tokushima University
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Nagamachi, Akihiro
Tokushima University
Matsuura, Tetsuya
Tokushima University
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Sakai, Toshinori
Tokushima University
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Hamada, Daisuke
Tokushima University
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Nishisho, Toshihiko
Tokushima University
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Goda, Yuichiro
Tokushima University
Morimoto, Masatoshi
Tokushima University
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Mineta, Kazuaki
Tokushima University
Kimura, Tetsuya
Tokushima University
Nitta, Akihiro
Tokushima University
Higuchi, Tadahiro
Tokushima University
Hama, Shingo
Tokushima University
Jha, Subash C.
Tokushima University
Takahashi, Rui
Tokushima University
Fukuta, Shoji
Tokushima University
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Keywords | Spondylolysis
spondylolisthesis
growth plate
adolescents
children
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Content Type |
Journal Article
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Description | Spondylolysis is a stress fracture of the pars interarticularis, which in some cases progresses to spondylolisthesis (forward slippage of the vertebral body). This slip progression is prevalent in children and occurs very rarely after spinal maturation. The pathomechanism and predilection for children remains controversial despite considerable clinical and basic research into the disorder over the last three decades. Here we review the pathomechanism of spondylolytic spondylolisthesis in children and adolescents, and specifically the Tokushima theory of growth plate slippage developed from our extensive research findings. Clinically, we have observed the slippage site near the growth plate on MRI ; then, using fresh cadaveric spines, we found the weakest link against forward shear loading was the growth plate.We subsequently developed an immature rat model showing forward slippage after growth plate injury. Moreover, finite element analysis of the pediatric spine clearly showed increased mechanical stress at the growth plate in the spondylolytic pediatric spine model compared with the intact pediatric spine. Thus, spondylolysis progresses to spondylolisthesis (forward slippage) in children and adolescents with the growth plate as the site of the slippage. Repetitive mechanical loading on to the growth plate may serve to separate the growth plate and subsequently progress to spondylolisthesis.
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Journal Title |
The Journal of Medical Investigation
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ISSN | 13496867
13431420
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NCID | AA11166929
AA12022913
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Publisher | Faculty of Medicine Tokushima University
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Volume | 62
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Issue | 1-2
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Start Page | 11
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End Page | 18
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Sort Key | 11
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Published Date | 2015-02
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EDB ID | |
DOI (Published Version) | |
URL ( Publisher's Version ) | |
FullText File | |
language |
eng
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TextVersion |
Publisher
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departments |
Medical Sciences
University Hospital
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