Diagnostic utility of patient history and physical examination data to detect spondylolysis and spondylolisthesis in athletes with low back pain: A systematic review

Grødahl, Linn Helen J.; Fawcett, Louise; Nazareth, Madeleine; Smith, Richard L.; Spencer, Simon; Heneghan, Nicola R; Rushton, Alison

doi:10.1016/j.math.2016.03.011

Cited by 37 publications

(26 citation statements)

References 65 publications

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“…Recruitment was performed through announcements at the Sport Sciences Campus in Gemona of Udine University. Before being enrolled into the study, each athlete was interviewed to assess whether he or she fulfilled the following inclusion criteria: a) no surgery for lumbar pathology; b) no acute severe traumatic events such as a car accident that damaged the spine or because of a contact injury in sport or due to poor biomechanics; c) no documented medical history of spondylolistesis (because this condition has specific characteristics different from other common causes of LBP [ 7 , 15 , 31 , 32 ]; d) absence of any acute or chronic disease (like scoliosis, cervical diseases, autoimmune diseases, rheumatoid arthritis, osteoporosis, fibromyalgia, diabetes mellitus, cardiovascular disease, or tumors etc. ); e) no use of anabolic steroids or other doping substances; f) no use of vitamin D supplementation; and g) no pregnancy at study entry [ 7 , 14 , 33 ].…”

Section: Methodsmentioning

confidence: 99%

Low back pain and FokI (rs2228570) polymorphism of vitamin D receptor in athletes

Cauci

Migliozzi

Trombetta

et al. 2017

BMC Sports Sci Med Rehabil

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BackgroundLow back pain (LBP) is common in athletes. LBP can be detrimental to athletic performance and health. Factors predisposing to LBP in athletes remain elusive and require further studies. We investigated whether carriage of a specific genotype and/or allele of vitamin D receptor gene (VDR) FokI polymorphism (rs2228570) was a risk factor for LBP in athletes of different sports disciplines.MethodsThis genotype/phenotype association case-control study included 60 Italian athletes (25 females and 35 males; mean age 33.9 ± 13.3 years; body-mass-index 23.5 ± 3.5 kg/m2) of which 16.7% were swimmers, 11.7% soccer players, 11.7% volleyball players, 10.0% rugby players and other disciplines. VDR-FokI polymorphism was measured by PCR-RFLP in 24 athletes with LBP and 36 athletes without LBP episodes. Absence or presence of the FokI restriction site was denoted “F” and “f”, respectively. Other risk factors were evaluated by a questionnaire.ResultsThe homozygous FF genotype was found in 58.3% (14/24) of athletes with LBP versus 27.8% (10/36) of athletes without LBP, adjusted OR = 5.78, 95% CI 1.41–23.8, P = 0.015. The F allele was a 2-fold risk factor to develop LBP, adjusted OR = 2.55, 95% CI 1.02–6.43, P = 0.046, while f allele was protective. Exposure to vehicle vibrations ≥2 h daily, and family history of lumbar spine pathology were significant risk factors for LBP with OR = 3.54, and OR = 9.21, respectively.ConclusionsThis is the first study in which an association between VDR-FokI polymorphism and LBP in athletes was found. Further research is needed to extend our results, and to clarify the biochemical pathways associated with how vitamin D modulates LBP in athletes. The VDR-FokI polymorphism should be considered when developing genetic focused studies of precision medicine on health in athletes.Electronic supplementary materialThe online version of this article (doi:10.1186/s13102-017-0069-x) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Low back pain and FokI (rs2228570) polymorphism of vitamin D receptor in athletes

Cauci

Migliozzi

Trombetta

et al. 2017

BMC Sports Sci Med Rehabil

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“…28 Where LBP is associated with sports involv ing repetitive loading, coupled with the finding of a step deformity on palpation, screening for spondylolysis/spondylolis thesis should be considered. 22 The non operative management of spondylolysis/ spondylolisthesis results in successful outcomes for the majority of people, with the outcome unrelated to the pres ence of bone healing. 28 Only in the case of highgrade spondylolisthesis associ ated with neurological/cauda equina symptoms are surgical considerations indicated.…”

Section: Specific Lumbar Pathologymentioning

confidence: 99%

Understanding Adolescent Low Back Pain From a Multidimensional Perspective: Implications for Management

O’Sullivan¹,

Smith²,

Beales³

et al. 2017

J Orthop Sports Phys Ther

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“…Frequent reassessment of objective measures, provocative maneuvers, and the patient's subjective complaints (stiffness, pain, and spasms) throughout care is essential to capture change and modify treatments appropriately. Poor clinical utility has been found for spondylolysis special testing, for example, the one-legged hyperextension test [41,42].…”

Section: Discussionmentioning

confidence: 99%

Spondylolysis in Young Athletes: An Overview Emphasizing Nonoperative Management

Goetzinger

Courtney

Yee

et al. 2020

Journal of Sports Medicine

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Lumbar spondylolysis is a unilateral or bilateral defect of the pars interarticularis, an isthmus of bone connecting the superior and inferior facet surfaces in the lumbar spine at a given level. Spondylolysis is common in young athletes participating in sports, particularly those requiring repetitive hyperextension movements. The majority of young athletes are able to return to full sport participation following accurate diagnosis and conservative management, including a structured treatment program. Surgical intervention for isolated pars injuries is seldom necessary. A progressive physical therapy (PT) program is an important component of recovery after sustaining an acute pars fracture. However, there is a paucity of literature detailing PT programs specific to spondylolysis. Here, we provide an overview of the epidemiology, natural history, radiographic evaluation, and management of pars fractures in young athletes. In addition, a detailed description of a physiotherapy program for this population that was developed at a spine center within an academic medical center is provided.

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Diagnostic utility of patient history and physical examination data to detect spondylolysis and spondylolisthesis in athletes with low back pain: A systematic review

Abstract: No recommendations can be made utilising patient history data. Based on one low ROB study, step deformity palpation may be useful in diagnosing spondylolisthesis. No physical tests demonstrated diagnostic utility for spondylolysis. Further research is required.

Cited by 37 publications

References 65 publications

Low back pain and FokI (rs2228570) polymorphism of vitamin D receptor in athletes

Low back pain and FokI (rs2228570) polymorphism of vitamin D receptor in athletes

Understanding Adolescent Low Back Pain From a Multidimensional Perspective: Implications for Management

Spondylolysis in Young Athletes: An Overview Emphasizing Nonoperative Management

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