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First published on August 10, 2005, doi:10.1177/0363546505275645
This version was published on November 1, 2005
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The American Journal of Sports Medicine 33:1688-1693 (2005)
© 2005 American Orthopaedic Society for Sports Medicine

Lumbar Spondylolysis in Pediatric and Adolescent Soccer Players

Georges El Rassi, MD*, Masakazu Takemitsu, MD*, Patarawan Woratanarat, MD* and Suken A. Shah, MD*,{dagger},{ddagger}

From the * Department of Orthopaedics, Alfred I. duPont Hospital for Children, Nemours Children’s Clinic, Wilmington, Delaware, and the {dagger} Jefferson Medical College, Philadelphia, Pennsylvania

{ddagger} Address correspondence to Suken A. Shah, MD, Alfred I. duPont Hospital for Children, Department of Orthopaedics, 1600 Rockland Road, PO Box 269, Wilmington, DE 19899 (e-mail: sshah{at}nemours.org).

Background: Lumbar spondylolysis in young soccer players has not been studied extensively.

Purpose: The purpose of this study was to review lumbar spondylolysis in young soccer players, describe the causes, and report the results of nonoperative treatment emphasizing the cessation of activity for 3 months.

Study Design: Case series; Level of evidence, 4.

Methods: The authors reviewed 57 child and adolescent soccer players (35 boys and 22 girls) with lumbar spondylolysis who came to their outpatient clinic for back pain evaluation. These patients received different modalities of nonoperative treatment, including cessation of sports and wearing a thoracolumbosacral orthosis. Soccer skills, field position, side of dominant leg, age, initiating event of low back pain, duration of symptoms, and nonoperative treatment were reviewed. Clinical outcome of treatment was assessed by the Steiner-Micheli criteria at the most recent follow-up (minimum 2 years). The Fisher exact test was used to compare all the data.

Results: Of the patients, 43% noticed that pain started after a high-velocity kick. Thirty-three (58%) of 57 patients had excellent results with no pain during sports, 20 (35%) good, 3 (5%) fair, and 1 (2%) poor. Subjects who ceased playing soccer for 3 months had better results than those who did not comply with this restriction.

Conclusion: The authors recommend stopping sports for at least 3 months in cases of lumbar spondylolysis in young soccer players who hope to return to their previous level of play without back pain.

Key Words: lumbar spondylolysis • soccer players • nonoperative treatment • stopping sports




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