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Adolescent Spondylolysis: Management and Return to Play
William C Warner1, Rodrigo Góes Medéa de Mendonça
1Professor of Orthopaedics, Department of Orthopaedics, University of Tennessee and Campbell Clinic, Memphis, Tennessee.
Instructional Course Lectures
|June 9, 2017
Summary
Adolescent athletes with spondylolysis or spondylolisthesis often have minimal symptoms and may not need treatment. For symptomatic cases, non-surgical rehabilitation can help return to sports, with surgery reserved for severe or unresponsive cases.
Area of Science:
- Orthopedics
- Sports Medicine
- Adolescent Health
Background:
- Spondylolysis and spondylolisthesis are leading causes of low back pain in adolescents.
- Adolescent spinal growth and sports-related hyperextension stress contribute to these conditions.
- These conditions can manifest as stress fractures in the spine.
Purpose of the Study:
- To review the causes, presentation, and management of spondylolysis and spondylolisthesis in adolescent athletes.
- To outline treatment strategies, including non-surgical and surgical options.
- To discuss individualized return-to-sport protocols based on disease severity.
Main Methods:
- Literature review of common causes of low back pain in adolescents.
- Analysis of mechanical factors and sports-related stress on the adolescent spine.
- Evaluation of treatment outcomes for conservative and operative interventions.
Main Results:
- Many adolescent athletes with spondylolysis or low-grade spondylolisthesis are asymptomatic and require no intervention.
- Non-surgical treatment, including activity modification and rehabilitation, is effective for symptomatic athletes.
- Surgical intervention is indicated for severe cases (grade III-IV) or those refractory to conservative management.
Conclusions:
- Individualized treatment plans are crucial for managing adolescent spondylolysis and spondylolisthesis.
- Return to sports can be achieved for most athletes with appropriate, tailored management.
- Early diagnosis and intervention optimize outcomes and facilitate safe return to athletic activity.
