Competitive Sports and the Progression of Spondylolisthesis

Abstract

To consider the effects of several years of competitive sports training on children and adolescents with spondylolisthesis, we carried out a retrospective radiologic and clinical study of 86 young athletes with spondylolysis or spondylolisthesis (24 girls and 62 boys between the ages of 6 and 20 years). The mean degree of displacement was 10.1% at the beginning of the observation. The radiologic tests showed an increase in displacement over time in 33 athletes. The average progression of spondylolisthesis in this group was 10.5%. For 36 athletes, spondylolisthesis did not progress during the period of athletic training. In seven athletes, a decrease in the displacement was observed, from 17.9 to 8.9% on average. For 10 athletes, the course of spondylolisthesis could not be determined, because only one lateral radiograph was available. In spite of intensive daily training, the athletes had no symptoms during the entire period of observation, which lasted an average of 4.8 years. In light of our experiments, there is no justification for generally advising children and adolescents with limited spondylolytic spondylolisthesis not to take part in competitive sports.

Bilateral Pars Defects at the L4 Vertebra Result in Increased Degeneration When Compared With Those at L5: An Anatomic Study

“…Greater than 70% of the spondylolytic lesions were at the L5 vertebra, whereas approximately 15% were located at L4 [18]. Additional studies have verified these incidences in adults [25,38]. Forty-five-year followup determined that the spondylolysis was most common bilaterally and was associated with instability at the corresponding level [6].…”

Lumbar spine injuries in athletes

“…Children between the ages of 9 and 15 years who participate in athletic contests are at highest risk for progressive slippage. 24 The presenting symptoms are low-back pain exacerbated by extension, usually without radiculopathy. Patients may compensate with knee and hip flexion on ambulation, accompanied by shortened stride (Phalen-Dickson sign).…”

Prise en charge du spondylolisthesis par lyse isthmique a niamey, a propos de 20 cas

“…Cette proportion serait légèrement supérieure chez les japonais, les bantous et les esquimaux (21). Sur le plan professionnel plusieurs auteurs ont rapporté une relation avec une activité sportive intense et la découverte d'une lyse isthmique avec ou sans glissement (9,19,21).Certains auteurs par contre rapportent que l'activité sportive chez un adolescent ayant une lyse isthmique n'est pas forcement un facteur aggravant (12). Dans cette série 45% des patients exerçaient une activité physique intense du fait de leur profession et un patient était un grand sportif.…”

“…Une bonne fusion peut être obtenue par un abord antérieur avec greffe inter somatique. Un montage semi-rigide court associé ou non à une chirurgie discale par voie antérieure ou postérieure avec greffe ou cage inter-somatique est recommandé par plusieurs auteurs, surtout lorsque la hauteur du disque est conservée (8,9,12). Notre attitude thérapeutique dans cette série a consisté en une décompression radiculaire puis vissage pédiculaire sur montage rigide court car l'objectif principal était la sédation de la radiculalgie.…”