Nonspondylolytic etiologies of lumbar pain in the young athlete

Approximately 50% of adolescent athletes with persistent lumbar pain can be diagnosed with spondylolysis or spondylolisthesis. The remaining 50% will have suffered injury of the vertebral body, intervertebral disc, ring apophysis, pelvis, articular processes, spinous processes, interspinous ligament, or other soft tissues of the lumbar spine. The adolescent spine is prone to these injuries as a consequence of the growth spurt and skeletal immaturity. Accurate diagnosis is mandatory in order to achieve successful treatment. History, physical examination, imaging modalities, and precision spinal injections can be employed to accurately diagnose the source of the symptoms. Appropriate treatment measures can then be prescribed to optimally treat the adolescent spine injury.