Canadian Chiropractic Association

Objective: Technique description and verification of L5 pars interarticularis (L5PI) using diagnostic ultrasound (DUS).

Methods: Asymptomatic 10-year-old male subject was scanned with diagnostic ultrasound applying a linear array transducer (8–13 MHz) over L5/S1 facets; long-axis slide cephalad to capture both superior (SAP) and inferior articulating process (IAP) of L5. Contiguous hyperechoic cortex with deep acoustic shadowing between the SAP and IAP was assumed to be L5PI. To confirm in vivo technique representing L5PI, two spine models (plastic, human spine) were scanned to verify authors’ assumption. Metallic paperclip was placed over L5PI then DUS image captured. Lastly, a subject with known spondylolysis was imaged and sonographic appearance of L5PI compared.

Results: The structures localized with the metal paperclip on L5PI models were equivalent to the in vivo DUS image. Spondylolysis demonstrates an abrupt step-off defect at L5PI.

Conclusion: We report the first technique description and verification of the L5PI using DUS.

The future of any profession is in the hands of its students and early career practitioners. The Millennial generation of chiropractors embody attributes that are uniquely suited to the evolving landscape of 21st-century healthcare. Globalization and rapid advancements in technology demand different styles of communication, attitudes toward diversity, styles of professional engagement, and perhaps most importantly, idealism about the future. Millennial chiropractors have a clear vision for this future of the profession and are equipped to actualize that ideal.