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This Article Full Text Full Text (PDF) All Versions of this Article: 32/4/928    most recent 0363546503262194v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (7) Citing Articles via Google Scholar Google Scholar Articles by Miller, S. F. Articles by Swanson, K. Search for Related Content PubMed PubMed Citation Articles by Miller, S. F. Articles by Swanson, K. Related Collections Imaging Studies Spine Anatomy Children and Adolescents

Long-Term Functional and Anatomical Follow-up of Early Detected Spondylolysis in Young Athletes

Stephen F. Miller, MD^*,, Joseph Congeni, MD^, and Kenneth Swanson, MD

From the Sports Medicine Center, Children’s Hospital Medical Center of Akron, Akron, Ohio, and the Department of Pediatrics, Northeastern Ohio Universities College of Medicine, Rootstown, Ohio

^* Address correspondence to Stephen F. Miller, MD, 521 N Claypool Court, Virginia Beach, VA 23464 (e-mail: mille080{at}yahoo.com).

Background: Spondylolysis defects detected by nuclear scintigraphy but not by plain radiographs represent early lesions. Functional outcome and eventual bony union of these defects are unknown.

Hypothesis: Defects with greater degree of healing shortly after treatment will proceed to full bony union and better long-term functional outcome.

Study Design: Longitudinal cohort study.

Methods: Forty young athletes with early detected spondylolysis (radiograph negative, nuclear scintigraphy positive) were divided into 3 stages of healing by computed tomography scan. Functional outcome was assessed 7 to 11 years later using the low back outcome score and other factors. Degree of bony healing was assessed in volunteers.

Results: Thirty-two of 40 subjects (80%) completed the survey. Twenty-nine of 32 (91%) had good or excellent low back outcome scores. None required spinal fusion, but 1 required partial diskectomy. Functional outcome did not differ based on initial computed tomography results. Radiographic follow-up was obtained in 11 volunteers. None of the 7 bilateral defects healed, and 3 of these progressed to grade 1 spondylolisthesis. All 4 unilateral defects healed fully with bone.

Conclusions: Most young athletes conservatively treated for early spondylolysis maintain good functional outcome up to 11 years later. Unilateral defects can undergo full bony healing but may take longer than 12 weeks. Bilateral defects may undergo further degeneration and slip with time.

Key Words: spondylolysis • adolescents • functional outcome • computed tomography (CT) scan

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