Variables associated with active spondylolysis.

Area of Science:

• Orthopedics
• Radiology
• Sports Medicine

Background:

• Spondylolysis is a stress fracture of the pars interarticularis, often associated with low back pain in athletes.
• Accurate identification of risk factors is crucial for early diagnosis and management of spondylolysis.
• The Single Leg Hyperextension Test is a commonly used clinical assessment, but its diagnostic utility for active spondylolysis requires further investigation.

Purpose of the Study:

• To identify demographic, symptomatic, and physical variables associated with active spondylolysis.
• To determine the predictive value of the Single Leg Hyperextension Test in diagnosing spondylolysis.

Main Methods:

• Retrospective audit of clinical data from 82 patients with suspected spondylolysis referred for SPECT bone scans.
• Analysis of six exploratory variables: Age, Gender, Injury duration, Injury onset, Sports participation, and Single Leg Hyperextension Test result.
• Uni- and multivariate regression analysis to assess associations with SPECT bone scan-confirmed spondylolysis.

Main Results:

• Adolescent males (under 20 years) showed a significantly higher incidence of spondylolysis (p=0.01 for age and gender).
• Active spondylolysis was associated with being male and under 20 years old (odds ratio ~5).
• Adolescent males with suspected spondylolysis were 3.5 times more likely to have a positive bone scan; the Single Leg Hyperextension Test was not a significant predictor (p=0.47).

Conclusions:

• Age and gender are significant factors in the predisposition to spondylolysis.
• Clinicians should consider patient demographics, particularly age and gender, when assessing for spondylolysis.
• The Single Leg Hyperextension Test has limited predictive value for active spondylolysis and should not be relied upon solely for diagnosis.