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. 2016 Sep;6(6):615-25.
doi: 10.1055/s-0036-1586743. Epub 2016 Aug 10.

Athletic Population with Spondylolysis: Review of Outcomes following Surgical Repair or Conservative Management

Pavlos Panteliadis  1 , Navraj S Nagra  2 , Kimberley L Edwards  3 , Eyal Behrbalk  4 , Bronek Boszczyk  4
Affiliations

Athletic Population with Spondylolysis: Review of Outcomes following Surgical Repair or Conservative Management

Pavlos Panteliadis et al. Global Spine J. 2016 Sep.

Abstract

Study design: Narrative review.

Objective: The study aims to critically review the outcomes associated with the surgical repair or conservative management of spondylolysis in athletes.

Methods: The English literature listed in MEDLINE/PubMed was reviewed to identify related articles using the term "spondylolysis AND athlete." The criteria for studies to be included were management of spondylolysis in athletes, English text, and no year, follow-up, or study design restrictions. The references of the retrieved articles were also evaluated. The primary outcome was time to return to sport. This search yielded 180 citations, and 25 publications were included in the review.

Results: Treatment methods were dichotomized as operative and nonoperative. In the nonoperative group, 390 athletes were included. A combination of bracing with physical therapy and restriction of activities was used. Conservative measures allowed athletes to return to sport in 3.7 months (weighted mean). One hundred seventy-four patients were treated surgically. The most common technique was Buck's, using a compression screw (91/174). All authors reported satisfactory outcomes. Time to return to play was 7.9 months (weighted mean). There were insufficient studies with suitably homogenous subgroups to conduct a meta-analysis.

Conclusion: There is no gold standard approach for the management of spondylolysis in the athletic population. The existing literature suggests initial therapy should be a course of conservative management with thoracolumbosacral orthosis brace, physiotherapy, and activity modification. If conservative management fails, surgical intervention should be considered. Two-sided clinical studies are needed to determine an optimal pathway for the management of athletes with spondylolysis.

Keywords: conservative treatment; spondylolysis in athletes; surgical treatment.

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Figures

Fig. 1
Fig. 1
Non rigid lumbar brace. (Reproduced with permission, from Ossur UK Ltd.)
Fig. 2
Fig. 2
Thoracolumbosacral orthosis brace. (Reproduced with permission, from Ossur UK Ltd.)
Fig. 3
Fig. 3
Lumbosacral orthosis brace. (Reproduced with permission, from Ossur UK Ltd.)
Fig. 4
Fig. 4
Jewett brace. (Reproduced with permission, from Ossur UK Ltd.)
Fig. 5
Fig. 5
Buck procedure.
Fig. 6
Fig. 6
Buck procedure. Axial computed tomography and lateral X-ray. (Reproduced with permission from The Indian Journal of Orthopaedics, Wolters Kluwer.)
Fig. 7
Fig. 7
Scott procedure.
See this image and copyright information in PMC

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