George Michael, Suhas K Etigunta, Andy M Liu, Christopher Watterson, David L Skaggs, Kenneth D Illingworth
{"title":"The Utilization of MRI-Generated Synthetic CT in the Treatment of Chronic Bilateral Spondylolysis: A Case Report.","authors":"George Michael, Suhas K Etigunta, Andy M Liu, Christopher Watterson, David L Skaggs, Kenneth D Illingworth","doi":"10.2106/JBJS.CC.24.00522","DOIUrl":null,"url":null,"abstract":"<p><strong>Case: </strong>A 14-year-old male athlete presented with a 9-month history of low back pain, worse with hyperextension. Nonoperative management for bilateral L4 spondylolysis had been unsuccessful. The patient underwent a novel magnetic resonance imaging (MRI) that generated a synthetic computed tomography (sCT). MRI/sCT revealed nonunion of the spondylolysis with persistent edema. The patient underwent minimally invasive bilateral L4 robot-navigated intralaminar screw fixation. CT at 3 months demonstrated complete healing.</p><p><strong>Conclusion: </strong>This case is the first to document the use of MRI-generated sCT in the management of pediatric spondylolysis, offering improved assessment of both bony and soft tissue pathology in a single study without the ionizing radiation of traditional CT.</p>","PeriodicalId":14748,"journal":{"name":"JBJS case connector","volume":"15 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JBJS case connector","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2106/JBJS.CC.24.00522","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Case: A 14-year-old male athlete presented with a 9-month history of low back pain, worse with hyperextension. Nonoperative management for bilateral L4 spondylolysis had been unsuccessful. The patient underwent a novel magnetic resonance imaging (MRI) that generated a synthetic computed tomography (sCT). MRI/sCT revealed nonunion of the spondylolysis with persistent edema. The patient underwent minimally invasive bilateral L4 robot-navigated intralaminar screw fixation. CT at 3 months demonstrated complete healing.
Conclusion: This case is the first to document the use of MRI-generated sCT in the management of pediatric spondylolysis, offering improved assessment of both bony and soft tissue pathology in a single study without the ionizing radiation of traditional CT.
期刊介绍:
JBJS Case Connector helps improve patient care by providing the medical community with a journal that harnesses technology to provide information tools for discovery and reporting of unusual musculoskeletal problems, findings, treatment, and outcomes. Co-edited by Thomas W. Bauer, MD, PhD, and Ronald W. Lindsey, MD, JBJS Case Connector assists orthopaedic surgeons in the search for precedents, connections, and trends in their efforts to improve patient care. Using this unique journal, surgeons can find the commonalities between cases, benefit from the experience of their peers, and filter case information by many important variables in order to provide the best possible care for orthopaedic patients. This cross-referenced online journal includes thousands of orthopaedic case reports. It compiles symptoms, conditions, and demographic details to empower surgeons to find cases similar to theirs. Surgeons can mine the database to reveal emerging trends and identify patterns, distinguishing between truly rare cases and repeated, related single instances of a larger problem. The JBJS Case Connector Image Quiz feature provides interactive quizzes based on images from content published by JBJS and includes a discussion area for further exploration of ideas and concepts. The JBJS Image Quiz app for iPad and iPhone is available in the App Store. Contributions to JBJS Case Connector are welcomed from anywhere in the world and are considered on their merits. Articles must be written in English and should be submitted as outlined in the Instructions to Authors. All authors must abide by the JBJS ethics policies and all submissions to JBJS Case Connector are covered by the JBJS embargo policy.