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Prevalence of Spondylolysis in Symptomatic Adolescent Athletes

An Assessment of Sport Risk in Nonelite Athletes

Selhorst, Mitchell, DPT, OCS*; Fischer, Anastasia, MD; MacDonald, James, MD, MPH

doi: 10.1097/JSM.0000000000000546
Original Research: PDF Only

Objective: To assess the risk of spondylolysis by sport in nonelite adolescent athletes with low back pain (LBP).

Design: Retrospective case series.

Setting: Hospital-based sports medicine clinic.

Patients: The medical charts of 1025 adolescent athletes with LBP (age 15 ± 1.8 years) were examined; 308 (30%) were diagnosed with a spondylolysis.

Assessment of Risk: Risk of spondylolysis was assessed in 11 sports for males and 14 sports for females.

Main Outcome Measure: Relative risk of diagnosis of spondylolysis injury.

Results: The risk of spondylolysis differed by sex with baseball (54%), soccer (48%), and hockey (44%) having the highest prevalence in males and gymnastics (34%), marching band (31%), and softball (30%) for female athletes. Baseball was the only sport to demonstrate a significant increased risk of spondylolysis.

Conclusions: The sports with the greatest risk of spondylolysis in adolescent athletes in this study were not consistent with published literature. Clinicians should be cautious generalizing high-risk sports to their practice, as geographic region and level of the athlete may significantly influence the incidence of spondylolysis in the population they are treating.

*Sports and Orthopedic Physical Therapy, Nationwide Children's Hospital, Columbus, Ohio; and

Division of Sports Medicine, Nationwide Children's Hospital, Columbus, Ohio.

Corresponding Author: Mitchell Selhorst, DPT, OCS, 396 E Dunedin Rd, Columbus, Ohio 43214 (

The authors report no conflicts of interest.

Received May 09, 2017

Accepted September 07, 2017

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