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    Area of Science:

    • Orthopedics
    • Sports Medicine
    • Radiology

    Background:

    • Acute low-back pain in athletes can present subtly.
    • Spondylolysis, a stress fracture, may not be evident on initial examination or standard radiographs.

    Purpose of the Study:

    • To highlight the diagnostic challenges of spondylolysis in young athletes.
    • To present an effective non-surgical management strategy for subtle spondylolysis.

    Main Methods:

    • Case report of a 13-year-old female athlete with recurring lumbosacral pain.
    • Utilized radiographs and technetium bone scan for diagnosis.
    • Implemented activity restriction, flexion exercises, and orthotic immobilization.

    Main Results:

    • Initial conservative treatments (activity restriction, exercises) were ineffective.
    • Radiographs and bone scan revealed subtle stress fractures.
    • Orthotic immobilization led to symptom resolution.

    Conclusions:

    • Spondylolysis should be considered in young athletes with persistent low-back pain.
    • Advanced imaging like bone scans can detect subtle fractures.
    • Orthotic immobilization is an effective treatment for spondylolysis.
    • Surgical intervention may be necessary for refractory cases.