Results of Conservative Treatment versus Surgical Repair in Treatment of Spondylolysis in Adolescents and Young Adults

Abstract

pondylolysis is a unilateral or bilateral defect in the pars interarticularis, which results from acute trauma or repetitive microtrauma. It is a common cause of lower back pain in young adults and adolescents, especially in those participating in sporting activities. It was found that 47% of patients below the age of 18 presenting to a sports medicine clinic with back pain had spondylolysis compared to 5% of adults above the age of 21 presenting with similar lower back pain symptoms.(1) Most commonly, Spondylolysis happens at the pars interarticularis of L5, representing 85% to 95% of cases; L4 represents 5% to 15% of cases. It is estimated that the prevalence of spondylolysis in the general population is between 3% and 6%(2-3). The typical presentation is lower back pain or pain radiating to the butt and/or posterior thigh. Physical examination demonstrates pain that is increased by extension of the lumbar spine and hamstring tightness and patients often describe it as diffuse and dull. (5) Diagnosis of spondylolysis begins with a series of plain anteroposterior, lateral, and oblique lumbar radiographs. When plain radiographs are normal and the patient history and physica