Table 1

Summary of included studies

Lead author (year of publ.)Inclusion criteriaParticipantsStudy designObjectiveTarget conditionReference standard and description of techniqueIndex test and description of techniqueSen and Spe[95% CI]
Kobayashi18
(2013)
LBP without neurological Sx
Age <18
Active in sports
Period of study N/A
n=200
Mean age 14.1 years
Male/female 144/56
Prospective, consecutive, cohort study1. Evaluate the usefulness of MRI
2. Evaluate specific clinical features of active spondylolysis
Early stage spondylolysis CT
— Reverse gantry angle in the plane parallel to the pars interarticularis only for the vertebral body corresponding to the area of the high intensity change seen on MRI
MRI
— Sagittal T2W images
— Sagittal STIR
— Axial T1W images
— Axial T2W images
— Axial STIR images
Excluded from quantitative synthesis
Masci19
(2006)
LBP
Age10–30 years
Engaging in regular activity
Period of study N/A
n=71
Age <25 (of those found +ve to SPECT)
Male/female 29/10
Prospective, cohort study1. To evaluate the usefulness of the one-legged hyperextension test
2. To evaluate the effectiveness of MRI in detecting active spondylolysis
Active spondylolysis SPECT-CT
— SPECT—A standard dose of 99Tcm–MDP was injected. Planar and SPECT images were obtained about 3 hours after injection
— CT—Images were acquired in the reversed gantry axial plane
MRI
— Sagittal T1W images
— Sagittal T2W pre-saturated images
— Axial T2W fat pre-saturated images
— Reverse-gantry oblique axial STIR images
Sen 0.80
[0.66, 0.90]
Spe 1.00
[0.99, 1.00]
Campbell20
(2005)
Extension LBP
Adolescent and young adults
Period of study N/A
n=72
Mean age 16 years
Male/female 45/27
Prospective, cohort study1. To determine the level of correlation of MRI with SPECT-CT
2. To determine if MRI can effectively replace SPECT-CT
Pars fracture SPECT-CT
— SPECT—Procedure was initiated approximately 3 hours after administration of an appropriate paediatric dose of 99Tcm–HDP
— CT-Images were acquired in the reverse-angle axial plane
MRI
— Sagittal T1W
— Reverse-angle oblique axial T1W images
— Sagittal 3D spoiled gradient echo sequence
— Sagittal STIR images (at times these were replaced with T2W)
— Reverse-angle oblique axial STIR images
Sen 0.89
[0.76, 0.96]
Spe 0.97
[0.94, 0.99]
Yamane21
(1993)
Extension LBP without neurological Sx
Age <19 years
All modalities performed within one month of initial consultation
Period of study June 1991 to May 1992
n=79
Mean age 14.6 years
Male/female
59/20
Prospective, consecutive, cohort studyReport the significance of a hypo-intense signal in the pars-interarticularis in the early diagnosis of spondylolysisEarly stage spondylolysis CT
—Transverse views were obtained. Slices were made parallel to the vertebral arch
—Results were compared with MRI based on initial and follow-up CT scan
MRI
Imaging was performed in the coronal and sagittal planes using:
—T1W images
—T2W images
Sen 0.97
[0.87, 1.00]
Spe 0.92
[0.85, 0.96]
  • LBP, low back pain; N/A, not available; publ., publication; Sx, symptoms; STIR, short tau inversion recovery, SEN, sensitivity; SPE, specificity; <, below; +ve, Positive; 99Tcm-MDP, Technetium 99 methylene diphosphonate; 99Tcm-HDP, Technetium 99 hydroxymethyl diphosphonate; T1W, T1 weighted; T2W, T2 weighted.