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Return to play after spondylolysis: An overview.

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This review of reviews on spondylolysis in athletes found limited evidence on return to play (RTP) strategies. Both conservative and surgical treatments aid RTP, but high-quality research is needed for definitive guidance.

Keywords:
Pars interarticularisReturn to playReturn to sportsSpondylolysis

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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.