Magnetic resonance imaging (MRI) vs. computed tomography (CT) in the diagnosis and classification of spondylolysis and spondylolisthesis—a narrative review

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Background and Objective: Spondylolysis is a lysis of the pars interarticularis, a component of the posterior arch of the vertebral body, in the face of repeated overuse and stress phenomena generally associated with sports in children and adolescent patients. This entity is one of the most common causes of low back pain in this age group. The diagnosis can be made using various imaging techniques, with computed tomography (CT) being considered the gold standard, as it provides the best visualization of the fracture, its extension and orientation, as well as an assessment of the entire bony skeleton. It is essential to understand the physiopathology and natural evolution of the disease as well as to know the typical findings of this disease in each imaging technique in order to be able to make a diagnosis in early stages of the disease. In this paper, we will review the clinical manifestations and typical radiologic findings of spondylolisthesis and spondylolisthesis, which allow a correct and early diagnosis. Methods: The literature available in English from 1976 (when the first publications on the diagnosis of this pathology appeared) up to the present day has been used for this review. Key Content and Findings: In this review we will review the etiology, etiopathogenesis and natural evolution of spondylolysis and spondylolisthesis, we will place special emphasis on the radiological findings in magnetic resonance imaging with a view to an early diagnosis that allows us to slow down the evolution of the disease in its initial stages and we will look at the advantages and disadvantages of each technique. Conclusions: Spondylolysis is an increasingly frequent entity due to the increase in sporting activity at younger and younger ages, so radiologists should consider its existence in patients with low back pain and know the radiological signs that allow us to make an early diagnosis.

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