Abstract
Spondylolysis is an osseous defect of the pars interarticularis, thought to be a developmental or acquired stress fracture secondary to chronic low-grade trauma. It is encountered most frequently in adolescents, most commonly involving the lower lumbar spine, with particularly high prevalence among athletes involved in sports requiring repetitive hyperextension. Spondylolysis can be asymptomatic or can be a cause of spine instability, back pain, and radiculopathy. It is important to determine the staging and type of spondylolysis via radiological means in order to assess bony healing and return to play. Whereas MRI can be used for early detection, bone scan is used to differentiate between active lesion and chronic cases. Multislice CT with multiplanar reformats is the most accurate modality for detecting the bony defect and may also be used for assessment of osseous healing. The present report investigates into the radiological follow up and clinical recovery guiding return to play in an athlete with multi level terminal stage spondylolysis.
Keywords: spondylolysis, athlete, return to play.
References
- Hardcastle P H. Repair of spondylolysis in young fast bowlers. J Bone Joint Surg Br. 1993;75(3):398–402.
- Vrable A, Sherman A L. Elite male adolescent gymnast who achieved union of a persistent bilateral pars defect. Am J Phys Med Rehabil. 2009;88(2):156–160.
- Reitman C A, Esses S I. Direct repair of spondylolytic defects in young compe-titive athletes. Spine J. 2002;2(2):142–144.
- Iwamoto J, Sato Y, Takeda T, Matsumoto H. Return to sports activity by athletes after treatment of spondylo-lysis. World J Orthod. 2010;1(1):26–30.
- Chung CH, Chiu HM, Wang SJ, Hsu SY, Wei YS: Direct repair of multiple levels lumbar spondylolysis by pedicle screw laminar hook and bone grafting: clinical, CT, and MRI assessed study. J Spinal Disord Tech 20:399–402, 2007
- Ogawa H, Nishimoto H, Hosoe H, Suzuki N, Kanamori Y, Shimizu K: Clinical outcome after segmental wire fixation and bone grafting for repair of the defects in multiple level lumbar spondylolysis. J Spinal Disord Tech 20:521–525, 2007.
- Soler T, Calderon C. The prevalence of spondylolysis in the Spanish elite athlete. Am J Sports Med2000;28:57-62
- Fujii, S. Katoh, K. Sairyo, T. Ikata, N. Yasui Union of defects in the pars interarticularis of the lumbar spine in children and adolescents the radiological outcome after conservative treatment. J Bone Joint Surg [Br] 2004;86-B:225-31.
- Tonetti, A. Leone, M. Marino, A. Semprini, V. Zecchi, C.Colosimo; Lumbar spondylolysis: the role of imaging. Poster No.: C-0830, Congress: ECR 2016
- Morita T, Ikata T, Katoh S, et al. Lumbar spondylolysis in children and adolescents. J Bone Joint Surg [Br] 1995;77: 620–5.
Corresponding Author
Ashay Jadhav
Postgraduate Resident, Department of Sports Medicine,
NSNIS, Patiala, Punjab, India
DOI: https://dx.doi.org/10.18535/jmscr/v6i6.120
