Management of spondylolysis and low-grade spondylolisthesis in fine athletes. A comprehensive review.
Management of spondylolysis and low-grade spondylolisthesis in fine athletes. A comprehensive review.
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DOI：
10.1007/s00590-014-1560-7
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发表时间：
2015-07-01
期刊：
影响因子：
--
通讯作者：
Korovessis, Panagiotis
中科院分区：
文献类型：
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作者：
Bouras, Theodoros;Korovessis, Panagiotis
目的：为优秀运动员峡部型腰椎滑脱和轻度椎体滑脱的病因、发病率、诊断和治疗及恢复运动提供循证资料。设计：这是一篇综合性的文献综述。以运动员、峡部裂、轻度峡部裂、治疗和恢复运动为关键词，对1973年至2014年的MEDLINE进行了全面检索。结果：最初共纳入了228篇文章，最终纳入了74个病例系列和综述，因为它们涉及了症状性峡部峡部裂和轻度（Meyerding I和II）峡部滑脱的优秀运动员的发病率、诊断、治疗和恢复。13项研究报道手术治疗（194例，平均年龄19岁），14项研究报道保守治疗（589例，平均年龄15.7岁）。保守治疗和手术治疗的成功率分别为85%和87.8%。结论：包括物理治疗和支具在内的保守治疗是治疗优秀运动员症状性峡部裂和轻度峡部滑脱的主要方法。如果后续治疗失败，则决定手术治疗（部分修复和短融合）。手术后恢复比赛的时间从6个月到12个月不等，禁止参加碰撞运动。恢复比赛主要取决于特定的体育活动。
OBJECTIVE: To provide evidence-based data about the aetiology, incidence, diagnosis and treatment of isthmic lumbar spondylolysis and low-grade spondylolisthesis and return to athletic activities in fine athlete.DESIGN: This is a comprehensive literature review. A thorough MEDLINE search in the period from 1973 to 2014 with the keywords: athlete, spondylolysis, low-grade spondylolisthesis, treatment and return to athletic activities was conducted.RESULTS: A total of 228 articles were initially enrolled from the search, and 74 case series and reviews were finally included because they referred to incidence, diagnosis, treatment and return to play in fine athletes with symptomatic isthmic spondylolysis and low-grade (Meyerding I and II) spondylolisthesis. There were 13 studies reporting surgical treatment (194 patients of average age 19 years) and 14 studies with conservative treatment (589 patients of average age 15.7). The percentage of athletes who were successfully treated with conservative or operative treatment was 85 and 87.8%, respectively.CONCLUSION: Conservative treatment including physiotherapy and bracing is the mainstay in the treatment of symptomatic spondylolysis and low-grade isthmic spondylolisthesis in fine athletes. If consequent treatment fails, the operative treatment (pars repair and short fusion) is decided. Return to play following surgery varies from 6 to 12 months with prohibition in collision sports. Return to play is mostly depended on specific sport activity.