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Spondylolysis: a critical review
1Puget Sound Sports and Spine Physicians, Seattle, Washington, USA. psssp@halcyon.com
British Journal of Sports Medicine
|December 29, 2000
Summary
Spondylolysis, a stress fracture of the spine, is common but often asymptomatic. Symptomatic cases, particularly in adolescent athletes, require rest, rehabilitation, and possibly bracing or surgery.
Area of Science:
- Orthopedics
- Sports Medicine
- Radiology
Background:
- Spondylolysis involves a fatigue fracture in the pars interarticularis of the neural arch.
- While radiographically common, most spondylolysis cases are asymptomatic.
- Symptomatic pars lesions are a significant concern in adolescent athletes.
Purpose of the Study:
- To review current literature on spondylolysis.
- To understand its natural history, pathophysiology, diagnosis, and treatment.
Main Methods:
- Comprehensive literature search including MEDLINE and textbooks.
- Review of over 125 articles based on scientific and historical merit.
- No controlled clinical trials were identified for inclusion criteria.
Main Results:
- Isthmic spondylolysis is a fatigue fracture of the pars interarticularis.
- High prevalence in the general population, mostly asymptomatic.
- Adolescent athletes are particularly affected by symptomatic spondylolysis.
Conclusions:
- Optimal diagnostic and treatment strategies for spondylolysis are not well-defined.
- Imaging plays a role in diagnosis.
- Treatment involves rest, physical rehabilitation, and potentially bracing or surgery.