UMEM Educational Pearls

Title: Spondylolysis

Keywords: back pain, sports injury (PubMed Search)

Posted: 2/14/2016 by Brian Corwell, MD
Click here to contact Brian Corwell, MD

Spondylolysis

Prevalence 3-6% in the general population (Higher in athletes)

Location: L4 (5-15% of cases) & L5 (85-95% of cases)

Population: More likely in the skeletally immature athlete due to the vulnerability of the immature pars interarticularis to repeated stress

Symptoms: Lumbar pain worse with extension

Higher risk sports: Gymnastics, diving, weightlifting, wrestling

Treatment: Bracing and activity modification, physical therapy

- Good results in 80% with conservative management allowing return to play.

- Those who fail benefit from iliac crest bone grafting and posterolateral fusion.

-Return to play is controversial in this group

Please review th images below for anaomy and imaging appearence

http://orthoinfo.aaos.org/figures/A00053F01.jpg

http://www.sonsa.org/images/spondylolysis.jpg

http://www.physio-pedia.com/images/2/22/Spondylolysis_x_ray_.docx.jpg

References

Huang P.et al.Return-to-Play Recommendations After Cervical, Thoracic, and Lumbar Spine Injuries: A Comprehensive Review. Sports Health2016 Jan;8(1):19-25.