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Review
. 2020 Feb;10(1):89-101.
doi: 10.1177/2192568218823695. Epub 2019 Feb 24.

The Incidence of Pars Interarticularis Defects in Athletes

Samuel Tawfik  1   2 , Kevin Phan  1   3 , Ralph J Mobbs  3   4 , Prashanth J Rao  3   5   6
Affiliations
Review

The Incidence of Pars Interarticularis Defects in Athletes

Samuel Tawfik et al. Global Spine J. 2020 Feb.

Abstract

Study design: Literature review.

Objective: To conduct a literature review of studies reporting the incidence of pars interarticularis defects in athletes of specific sports, in order to allow more targeted prevention and treatment strategies to be implemented for the groups at highest risk.

Methods: Electronic searches were performed using PubMed, Ovid Medline, EMBASE, Google Scholar, Cochrane Database of Systematic Reviews, and Cochrane Database of Controlled Trials from their dates of inception to September 2017, with the following keywords: "spondylolysis," "sports," "low back pain," and "pars defects."

Results: A total of 509 total articles were retrieved, of which 114 were used in the final review. The incidence of pars interarticularis defects was found to be highest in diving (35.38%), cricket (31.97%), baseball/softball (26.91%), rugby (22.22%), weightlifting (19.49%), sailing (17.18%), table tennis (15.63%), and wrestling (14.74%). Only 5 studies reported the management instituted for their participants, and these were all case reports. Of 74 players with spondylolysis in these studies, 70 (94.59%) underwent conservative treatment and 4 (5.41%) underwent surgical treatment. 61 (82.43%) returned to their previous level of play, 6 (8.11%) retired, and the disposition of the final 7 was not reported.

Conclusion: The current medical literature provides good evidence that the incidence of pars interarticularis defects is higher in the athletic population, with the highest incidence in diving. There remains no gold standard protocol for the management of pars interarticularis defects. Further research is required to compare conservative therapy to surgical therapy and to compare the various surgical techniques to each other.

Keywords: athletes; incidence; low back pain; prevalence; review; spondylolysis; sports.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Diagrammatic representation of 2 lumbar vertebra. The pars interarticularis is the region between the lamina, pedicle, superior articular process, and inferior articular process of each vertebra. Each vertebra resembles a “Scotty dog,” with defect across the pars interarticularis producing the “Scotty dog collar” sign.
Figure 2.
Figure 2.
X-ray of the lumbar spine (lateral view) showing a spondylolytic defect.
Figure 3.
Figure 3.
X-ray of the lumbar spine (axial view) showing bilateral spondylolytic defects. This radiograph is from one of the author’s patients.
Figure 4.
Figure 4.
PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flowchart. A total of 504 original articles were retrieved. A total of 114 articles were used in the final review with quantitative data retrieved from 42 of these articles.
See this image and copyright information in PMC

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