We read the article “Management of lumbar spondylolysis in the adolescent athlete:
a review of over 200 cases” by Choi et al [
[1]
] with great interest and discussed it at length with our professional peer group.
We seek the author's comments on our salient and pertinent queries:
- 1.The usefulness of bone stimulation in the protocol as previous studies and this study result showed no effect of the bony union on symptomatic relief [[2]]. Considering the added financial burden and difficult compliance, would you suggest it as an essential component of conservative protocol?
- 2.Why keep the endpoint as three months for everyone before commencing strengthening exercises? Few studies have suggested individualizing the beginning of activity as early as possible, varying with different sports [[3]]. Did this prolonged cessation of activity with bracing result in muscle atrophy?
- 3.The reason for TSLO bracing when the level most commonly involved was at the lumbosacral junction, where the L–S belt could have been used with or without leg extensions [[4]]. Were the patients compliant with 23 hours of bracing, and did this prolonged bracing result in muscle atrophy?
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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
- 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
- Pediatric return to sports after spinal surgery.Sports Health. 2016; 8: 331-335https://doi.org/10.1177/1941738116634685
- Spinal cord injuries.Med J Armed Forces India. 2010; 66: 325-328https://doi.org/10.1016/S0377-1237(10)80009-7
Article info
Publication history
Published online: February 20, 2023
Accepted:
February 13,
2023
Received:
December 28,
2022
Footnotes
FDA device/drug status: Not applicable.
Author disclosures: SSR: Nothing to disclose. VK: Nothing to disclose. PS: Nothing to disclose.
Identification
Copyright
© 2023 Elsevier Inc. All rights reserved.
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- Letter to the editor regarding, “Management of lumbar spondylolysis in the adolescent athlete: a review of over 200 cases” by Choi et alThe Spine JournalVol. 23Issue 6
- PreviewAs 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.
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