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Spondylolysis: Assessment and Treatment in Youth Athletes

  • Sports Medicine Rehabilitation (BJ Krabak and B Liem, Section Editors)
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Abstract

Purpose of Review

Spondylolysis is a defect in the pars interarticularis that can range from a stress reaction to an overt fracture. It is the most common cause of low back pain in adolescent athletes, with a higher incidence in sports involving repetitive hyperextension. The purpose of this review is to discuss the work-up and management of spondylolysis in the youth athlete.

Recent Findings

A thorough history and physical examination is important in the evaluation of a patient with suspected spondylolysis, but there is no one examination maneuver with high sensitivity and specificity. Although plain radiography is the first imaging study ordered, it is frequently non-diagnostic and generally requires follow-up bone scan, CT, or MRI. The use of bracing appears to have improved short-term relief of pain but similar long-term outcomes when compared to conservative management without bracing. If pain persists despite 6–9 months of conservative management, surgery is an option and has excellent outcomes.

Summary

In this review article, aspects of the history that can assist in making a diagnosis are explored. Imaging options are also discussed to help the physician order the most efficacious test for each patient. Conservative management options are reviewed, along with a brief discussion of surgical management. Overall, the current literature suggests an excellent outcome with return to previous sport for most young athletes with spondylolysis.

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Correspondence to Lauren F. Vernese.

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Vernese, L.F., Chu, S.K. Spondylolysis: Assessment and Treatment in Youth Athletes. Curr Phys Med Rehabil Rep 5, 75–82 (2017). https://doi.org/10.1007/s40141-017-0151-z

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