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Effect of Sports Modification on Clinical Outcome in Children and Adolescent Athletes with Symptomatic Lumbar Spondylolysis

El Rassi, Georges MD; Takemitsu, Masakazu MD; Glutting, Joseph PhD; Shah, Suken A. MD

American Journal of Physical Medicine & Rehabilitation: December 2013 - Volume 92 - Issue 12 - p 1070–1074
doi: 10.1097/PHM.0b013e318296da7e
Original Research Articles

Objective This cohort study aimed to report the compliance of young athletes with nonoperative treatment and to clarify the role of sports modification on clinical outcome of symptomatic spondylolysis.

Design This study included patients with a chief complaint of low back pain participating in regular sports activity, having spondylolysis, and being treated and followed up between 1990 and 2002 in the authors’ hospital.

Results One hundred thirty-two athletes were included in this study: 78 males and 54 females. The mean age of the patients was 13 yrs (range, 7–18 yrs). Only 56 patients (42.4%) were compliant to nonoperative treatment. Eighty-six patients (65%) stopped all sports activities for at least 3 mos, and 46 patients (35%) stopped exercising for a variable period of less than 3 mos. The grading of clinical outcome after nonoperative treatment was as follows: excellent in 48 patients (36.4%), good in 74 patients (56.1), fair in 6 patients (4.5%), and poor in 4 patients (3%). The patients who stopped sports for at least 3 mos were 16.39 times more likely to have an excellent result than those who did not stop sports. Bony healing on radiographs did not correlate with clinical outcome.

Conclusions Timely cessation of sports activity for 3 mos is considered an effective method of nonoperative treatment for young athletes with symptomatic lumbar spondylolysis.

From the Department of Orthopedic Surgery, Balamand University, Beirut, Lebanon (GE, MT, SAS); Division of Orthopedics, National Center of Neurology and Psychiatry, Tokyo, Japan (MT); University of Delaware, Newark (JG); and Department of Orthopedic Surgery, Jefferson Medical College, Philadelphia, Pennsylvania (SAS).

All correspondence and requests for reprints should be addressed to: George El Rassi, MD, Saint George Hospital, PO Box 166378 Ashrafieh, Beirut 1100 2807 Lebanon.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

© 2013 by Lippincott Williams & Wilkins