The Diagnosis and Management of Lumbar Spondylolysis

Spondylolysis is a common cause of low back pain in adolescent athletes. Despite the frequency with which it occurs, there are no controlled trials on treatment and only limited comparative studies between the different imaging modalities available. Given this, there are substantial disagreements among authors as to the optimal means of diagnosing and treating this condition. Based on the current medical literature, however, nuclear imaging with bone scan and single-photon emission computed tomography would appear to represent the best diagnostic screening tool, although additional studies, particularly computed tomography, may be necessary to accurately diagnose and treat an affected athlete. An essential component of treatment is relative rest. Issues related to the diagnosis and management of adolescent athletes with spondylolysis will be addressed, and defined strategies for diagnosis and treatment are presented.