As sports medicine physiatrists who routinely treat acute and chronic lumbar spondylolysis
in adolescent athletes, we read the article by Choi et al. [
[1]
] with great interest. We were impressed by this large case series and commend the
authors for publishing their work since it moves us closer to answering important
clinical questions in this population. In this study, the methods reflect many standards
of care in adolescent athletes, including competitive sports cessation, bracing considerations,
physical therapy and a gradual return to sports after 12 weeks of care. Points of
discussion or contention include the routine use of bone stimulators, the use of custom
thoracolumbosacral orthoses worn 23 hours/day for 3 months, and the use of lumbar
facet joint injections for treating refractory symptoms or specific imaging findings
on initial magnetic resonance imaging (MRI).To read this article in full you will need to make a payment
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References
- Management of lumbar spondylolysis in the adolescent athlete: a review of over 200 cases.Spine J. 2022; 22: 1628-1633https://doi.org/10.1016/j.spinee.2022.04.011
- Conservative treatment for bony healing in pediatric lumbar spondylolysis.Spine (Phila Pa 1976). 2017; 42: E716-Ee20https://doi.org/10.1097/BRS.0000000000001931
- Conservative treatment of lumbar spondylolysis in childhood and adolescence: the radiological signs which predict healing.J Bone Joint Surg Br. 2009; 91: 206-209https://doi.org/10.1302/0301-620X.91B2.21256
- Elastic lumbar support versus rigid thoracolumbar orthosis for acute pediatric spondylolysis. a prospective controlled study.Spine (Phila Pa 1976). 2022; 48: 89-96https://doi.org/10.1097/BRS.0000000000004424
- Athletic population with spondylolysis: review of outcomes following surgical repair or conservative management.Global Spine J. 2016; 6: 615-625https://doi.org/10.1055/s-0036-1586743
- Nonoperative treatment of spondylolysis and grade I spondylolisthesis in children and young adults: a meta-analysis of observational studies.J Pediatr Orthop. 2009; 29: 146-156https://doi.org/10.1097/BPO.0b013e3181977fc5
- Outcome of conservative management in the treatment of symptomatic spondylolysis and grade i spondylolisthesis.Bull Hosp Jt Dis. 2019; 77: 172-182
Article info
Publication history
Published online: February 19, 2023
Accepted:
February 13,
2023
Received:
October 24,
2022
Footnotes
FDA device/drug status: Not applicable.
Author disclosures: JW: Nothing to disclose. EC: Nothing to disclose. PM: Nothing to disclose. JC: Nothing to disclose.
Identification
Copyright
© 2023 Elsevier Inc. All rights reserved.
