Long-Term Clinical Outcomes and Factors That Predict Poor Prognosis in Athletes After a Diagnosis of Acute Spondylolysis: A Retrospective Review With Telephone Follow-up

Abstract

® T t STUDY DESIGN:Retrospective review with telephone follow-up. T t BACKGROUND:Acute spondylolytic injuries have a dramatic impact on the young athlete. Excellent short-term clinical outcomes have been observed, but not enough is known about longterm clinical outcomes. T t OBJECTIVES:(1) To report long-term clinical outcomes for patients diagnosed with acute spondylolysis, and (2) to assess the prognostic ability of retrospective variables for long-term outcomes. T t METHODS: Patients from 2010 through 2013were retrospectively reviewed to identify patients and to obtain demographic, baseline, and shortterm outcomes. Long-term follow-up data were collected by telephone from patients diagnosed with acute spondylolysis to assess recurrence rate of low back pain, perceived outcome, pain, and functional ability. Patients were categorized as having a good or poor long-term outcome based on these measures. Logistic regression analysis was performed to assess the prognostic ability of the retrospective variables for long-term outcomes 3.4 years (range, 1.5-5.6 years) after treatment. T t RESULTS:One hundred twenty-one (71.6%) patients completed the follow-up questionnaire (48 female; mean age at baseline, 14.4 years). At follow-up, 81 (66.9%) patients were able to maintain their same or a higher level of sport. Recurrence of significant symptoms was reported by 55 (45.5%) patients, with 41 (33.9%) requiring medical treatment. The final logistic regression model revealed that female sex, adverse reaction during care, and multilevel injury were significant predictors of poor long-term outcome (R 2 = 0.22).

Tratamiento y vuelta a la práctica deportiva en jóvenes con diagnóstico de espondilosis. Revisión sistemática

“…También estudian el uso de órtesis sin obtener resultados claros acerca de su eficacia. Las principales órtesis usadas en los estudios analizados son toracolumbosacras y lumbosacras 17, [19][20][21][22]31 . También se incluyen otras ortesis alternativas 20,22,25 , pautándose incluso cambios en ella a lo largo del tiempo 25 .…”

“…Las intervenciones quirúrgicas aquí descritas no tienen un consenso en el tiempo de descanso o inmovilización ortopédica post-quirúrgica, pero comparando los que manejan tiempos inferiores 31 con los que manejan mayores 17,24,25 , se obtiene que los de menor reposo consiguen resultados mejores respecto a la curación y vuelta al deporte, lo que también se puede deber a la pequeña muestra que manejan o al tipo de operación realizada. En los conservadores, se establecen tiempos de medias cercanas a 2.5 meses 21, 22 . Se genera la hipótesis de si el tiempo de reposo afecta al retorno deportivo, lo cual se puede comprobar en los resultados de Selhorst et al 20 donde los pacientes con menos reposo vuelven al deporte antes que los de mayor periodo de descanso.…”

Spondylolysis in Young Athletes: An Overview Emphasizing Nonoperative Management

“…ese factors included bracing, type of injury (unilateral, bilateral, and spondylolisthesis), duration of symptoms, and previous episode of low back pain (LBP) [34]. We do not advocate for routine external bracing in this population.…”

An Alternative Model of Care for the Treatment of Adolescent Athletes with Extension-Based Low Back Pain: A Pilot Study.

“…14 The outcomes of adolescent athletes following treatment using the biomedical model are not ideal. [15][16][17] Diagnosis of adolescent LBP is associated with exposure to significant radiation and high imaging costs. 18 Adolescent athletes with LBP may have a worse prognosis regarding function than their nonathlete counterparts.…”

“…16 In patients with a spondylolysis, 42% had a poor clinical outcome and one in eight had to stop or reduce sport participation at long-term follow-up. 15,17 These findings become particularly important because the more days an adolescent experiences LBP, the higher the risk for chronic LBP as an adult. 20 The suboptimal clinical outcomes in adolescent athletes with LBP demonstrate the need to improve the model of care.…”