The Utilization of MRI-Generated Synthetic CT in the Treatment of Chronic Bilateral Spondylolysis

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.