Retroisthmic cleft of the vertebral arch

Case contributed by Dr Roberto Schubert


Handball player with back problems.

Patient Data

Age: 30
Gender: Male

Continuous dark sclerotic line in the right L5 vertebral arch with osteophytes, dorsal to the isthmus. This patient also had bilateral spondylolysis with minimal olisthesis.

Case Discussion

Retroisthmic clefts are the least common of six types of posterior vertebral arch defects (including persistent fusion anomalies):

  • neurocentral synchondrosis
  • retrosomatic cleft
  • spondylolysis
  • retroisthmic cleft
  • paraspinous cleft
  • spina bifida occulta

Other than isthmic spondylolysis, it lies dorsal to the inferior articular facet. Stress fracture from repetitive trauma is the most probable cause1.

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Case information

rID: 24469
Published: 19th Aug 2013
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included

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