{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T18:50:52Z","timestamp":1792003852225,"version":"4.4.0"},"reference-count":11,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:sec>\n<jats:title>OBJECT<\/jats:title>\n<jats:p>Lumbar spondylolysis and isthmic spondylolisthesis occur most commonly at only one spinal level. The authors report on 13 cases of lumbar spondylolysis with spondylolisthesis at multiple levels.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>During July 2007\u2013March 2012, multiple-level spondylolysis associated with spondylolisthesis was diagnosed in 13 patients (10 male, 3 female) at Qilu Hospital of Shandong University. The mean patient age was 43.5 \u00b1 14.6 years. The duration of low-back pain was 11.7 \u00b1 5.1 months. Spondylolysis occurred at L-2 in 2 patients, L-3 in 4 patients, L-4 in all patients, and L-5 in 5 patients. Spondylolysis occurred at 3 spinal levels in 3 patients and at 2 levels in 10 patients. All patients had spondylolisthesis at 1 or 2 levels. Japanese Orthopaedic Association and visual analog scale scores were used to evaluate preoperative and postoperative neurological function and low-back pain. All patients underwent pedicle screw fixation and interbody fusion or direct pars interarticularis repair.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Both low-back pain scores improved significantly after surgery (p &lt; 0.05). Postoperative radiographs or CT scans showed satisfactory interbody fusion or pars interarticularis healing. No breakage, dislodging, or loosening of the pedicle screw hardware was observed for any patient.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Multiple-level lumbar spondylolysis and spondylolisthesis occurred more often in men. Most multiplelevel lumbar spondylolysis occurred at 2 spinal levels and was associated with sports, trauma, or heavy labor. Multiplelevel lumbar spondylolysis occurred mostly at L3\u20135; associated spondylolisthesis usually occurred at L-4 and L-5, mostly at L-4. The treatment principle was the same as that for single-level spondylolisthesis.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2014.10.spine14415","type":"journal-article","created":{"date-parts":[[2014,12,19]],"date-time":"2014-12-19T15:02:58Z","timestamp":1419001378000},"page":"283-287","source":"Crossref","is-referenced-by-count":20,"title":["Multiple-level lumbar spondylolysis and spondylolisthesis"],"prefix":"10.3171","volume":"22","author":[{"given":"Xinyu","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lianlei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suomao","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yonghao","family":"Tian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanping","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianmin","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-spine14415","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"E542","DOI":"10.1097\/00007632-200112010-00021","article-title":"Combined dysplastic and isthmic spondylolisthesis: possible etiology","volume":"26","author":"Al-Khawashki","year":"2001"},{"key":"b2-spine14415","series-title":"J Spinal Disord Tech","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1097\/01.bsd.0000211253.67576.90","article-title":"Direct repair of multiple levels lumbar spondylolysis by pedicle screw laminar hook and bone grafting: clinical, CT, and MRI-assessed study","volume":"20","author":"Chung","year":"2007"},{"key":"b3-spine14415","series-title":"J Chiropr Med","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1016\/j.jcm.2009.04.003","article-title":"Chiropractic management of mechanical low back pain secondary to multiple-level lumbar spondylolysis with spondylolisthesis in a United States Marine Corps veteran: a case report","volume":"8","author":"Dunn","year":"2009"},{"issue":"1","key":"b4-spine14415","series-title":"Neurosurg Focus","first-page":"E1","article-title":"Isthmic spondylolisthesis","volume":"13","author":"Ganju","year":"2002"},{"key":"b5-spine14415","series-title":"J Bone Joint Surg Am","doi-asserted-by":"publisher","first-page":"713","DOI":"10.2106\/00004623-197557050-00031","article-title":"Double-level spondylolysis and transitional vertebra. Case report","volume":"57","author":"Grantham","year":"1975"},{"key":"b6-spine14415","series-title":"Surg Gynecol Obstet","first-page":"371","article-title":"Spondylolisthesis","volume":"54","author":"Meyerding","year":"1932"},{"key":"b7-spine14415","series-title":"J Spinal Disord Tech","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1097\/BSD.0b013e3180335c1f","article-title":"Clinical outcome after segmental wire fixation and bone grafting for repair of the defects in multiple level lumbar spondylolysis","volume":"20","author":"Ogawa","year":"2007"},{"key":"b8-spine14415","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1097\/00007632-198011000-00011","article-title":"Multiple lumbar spondylolyses","volume":"5","author":"Ravichandran","year":"1980"},{"key":"b9-spine14415","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"2346","DOI":"10.1097\/BRS.0b013e3181b4abbe","article-title":"Incidence of lumbar spondylolysis in the general population in Japan based on multidetector computed tomography scans from two thousand subjects","volume":"34","author":"Sakai","year":"2009"},{"key":"b10-spine14415","series-title":"J Bone Joint Surg Am","doi-asserted-by":"publisher","first-page":"17","DOI":"10.2106\/00004623-197557010-00003","article-title":"Fatigue fracture: the basic lesion is inthmic spondylolisthesis","volume":"57","author":"Wiltse","year":"1975"},{"key":"b11-spine14415","series-title":"J Can Chiropr Assoc","first-page":"142","article-title":"Rehabilitation of a patient with a rare multi-level isthmic spondylolisthesis: a case report","volume":"48","author":"Wong","year":"2004"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/22\/3\/article-p283.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/22\/3\/article-p283.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/22\/3\/article-p283.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T21:28:51Z","timestamp":1681594131000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/22\/3\/article-p283.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,3]]},"references-count":11,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/2014.10.spine14415","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2015,3]]}}}