Physical characteristics of patients with symptomatic lumbar spondylolysis who have recurrent low back pain after returning to sports.

INTRODUCTION: To determine the physical characteristics of patients with symptomatic lumbar spondylolysis (LS) who have recurrent low back pain after returning to sports. METHOD: Fifty-three adolescent patients with symptomatic LS participated in this study. Patients with symptomatic LS were assessed for flexibility, trunk muscle strength, and Functional Movement Screen (FMS) score, and then divided into two groups according to the degree of pain experienced one month after returning to sport. RESULTS: Twenty-four patients returned to their pre-injury sports level without pain (excellent group), while the remaining 29 patients had pain and decreased activity level during sports (pain group). The excellent group had a significantly higher shoulder mobility score on the FMS than the pain group, and the effect size was larger. However, there were no significant differences in body flexibility, muscle tightness, trunk muscle strength, or other FMS items. DISCUSSION: The most important finding of this study is that patients with LS who have recurrent low back pain after returning to sports are characterized by poor functional upper body movement. CONCLUSIONS: Because upper body functional movement pattern may be an important factor in the management of patients with symptomatic LS, preventive rehabilitation to enhance upper body mobility and motor control should be considered for these patients.

High defect stage, contralateral defects, and poor flexibility are negative predictive factors of bone union in pediatric and adolescent athletes with spondylolysis.

PURPOSE: To identify predisposition to spondylolysis and physical characteristics associated with "bone union" following conservative spondylolysis treatment among pediatric and adolescent athletes. METHODS: We retrospectively analyzed pediatric and adolescent athletes with spondylolysis who underwent conservative treatment and rehabilitation for three or more consecutive months following sports activity cessation. Patients with terminal spondylolysis or who did not discontinue sports activities were excluded. We compared physical fitness factors in the union and nonunion groups and examined the association between bone union and spondylolysis severity by logistic regression analysis. RESULTS: Of 183 patients with spondylolysis who underwent rehabilitation over a four-year period, 127 patients with 227 defects were included in the final analysis. Bone union was achieved in 66.5% (151/227) of the pars interarticularis defects and 70.1% (89/127) of the patients. On multivariate analysis, stage of pars interarticularis defect (odds ratio [OR], 0.26;p = 0.0027), stage of contralateral pars interarticularis defect (OR, 0.51;p = 0.00026), and straight leg-raising test (OR, 1.06;p = 0.028) were significantly associated with bone union. CONCLUSIONS: High defect stage, stage of the contralateral pars interarticularis defect, and poor flexibility were negative prognostic factors of bone healing in athletes with spondylolysis. J. Med. Invest. 65:126-130, February, 2018.