Return to play after spondylolysis: An overview

Area of Science:

• Sports Medicine
• Orthopedic Surgery
• Rehabilitation Science

Background:

• Spondylolysis is a stress fracture of the vertebrae, increasingly linked to specific athletic activities.
• Effective management is crucial for athletes to successfully return to sports (RTS).

Purpose of the Study:

• To systematically review existing reviews (RoR) on return to play (RTP) in athletes with spondylolysis.
• To summarize findings on conservative and surgical management strategies for spondylolysis.
• To identify gaps and provide recommendations for future research and clinical practice.

Main Methods:

• A systematic review of reviews was conducted using PubMed and Google Scholar.
• Included articles were published in English since 2015, adhering to PRISMA guidelines.
• Study quality was assessed using the AMSTAR-2 checklist, with data compiled and analyzed.

Main Results:

• Seven systematic reviews and meta-analyses, encompassing 51 primary studies, were included.
• Significant heterogeneity in methods and reporting was noted across primary studies.
• Study quality was predominantly low to critically low, necessitating cautious interpretation of findings.

Conclusions:

• Current evidence on RTP following spondylolysis is limited and inconclusive regarding the superiority of conservative versus surgical management.
• Surgical intervention may offer a better chance of RTP for athletes who have not responded to conservative treatment.
• High-quality, multicentered studies and consensus on RTP definitions and outcome measures are urgently needed.