Rita Grazina1, Renato Andrade2, Filipe Lima Santos3, José Marinhas4, Rogério Pereira5, Ricardo Bastos6, João Espregueira-Mendes7. 1. Serviço de Ortopedia e Traumatología, Centro Hospitalar Vila Nova de Gaia/Espinho, Portugal. Electronic address: rita.grazina@gmail.com. 2. Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal; Dom Henrique Research Centre, Portugal; Faculty of Sports of University of Porto, Porto, Portugal. Electronic address: randrade@espregueira.com. 3. Serviço de Ortopedia e Traumatología, Centro Hospitalar Vila Nova de Gaia/Espinho, Portugal. Electronic address: santos.filipe.lima@gmail.com. 4. Serviço de Ortopedia e Traumatología, Centro Hospitalar Vila Nova de Gaia/Espinho, Portugal; Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal. Electronic address: josemarinhas@gmail.com. 5. Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal; Dom Henrique Research Centre, Portugal; Faculty of Sports of University of Porto, Porto, Portugal; Faculty of Health Science of Fernando Pessoa University, Porto, Portugal. Electronic address: rp@espregueira.com. 6. Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal; Dom Henrique Research Centre, Portugal; Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil. Electronic address: rbastos@espregueira.com. 7. Dom Henrique Research Centre, Portugal; Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal; 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017, Barco, Guimarães, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga, Guimarães, Portugal; Orthopaedics Department of Minho University, Braga, Portugal. Electronic address: espregueira@dhresearchcentre.com.
Abstract
PURPOSE: Analyze the return to sports rate and timing after conservative and surgical treatment in athletes with spondylolysis. METHODS: Comprehensive search using Pubmed, Cochrane Library and SPORTDiscus databases to identify English language studies that assessed the return to sports after conservative or surgical treatment of symptomatic spondylolysis in athletes. The main outcome of interest was the return to sports rate and timing, as well as, the follow-up clinical and functional outcomes. RESULTS: A total of 14 trials (592 participants) were included. Eight and seven studies reported the outcomes of conservative and surgical approach, respectively. A total of 92% (n = 492) and 88% (n = 100) of athletes return to sports at any level, and 89% (n = 185) and 81% (n = 103) returned to their pre-injury level of sports for conservative and surgical approaches, respectively. The time to return to sports was 4.6 and 6.8 months for conservative and surgical approaches, respectively. CONCLUSIONS: Conservative management (bracing, sports modification and physiotherapy) of athletes with spondylolysis show excellent return to sports rates at any level and at the pre-injury level at a mean of 4.6 months. Those who fail the conservative treatment can be successfully managed with surgical treatment with a high rate of return to sports at 6.8 months. LEVEL OF EVIDENCE: Level IV, Systematic review of level IV studies.
PURPOSE: Analyze the return to sports rate and timing after conservative and surgical treatment in athletes with spondylolysis. METHODS: Comprehensive search using Pubmed, Cochrane Library and SPORTDiscus databases to identify English language studies that assessed the return to sports after conservative or surgical treatment of symptomatic spondylolysis in athletes. The main outcome of interest was the return to sports rate and timing, as well as, the follow-up clinical and functional outcomes. RESULTS: A total of 14 trials (592 participants) were included. Eight and seven studies reported the outcomes of conservative and surgical approach, respectively. A total of 92% (n = 492) and 88% (n = 100) of athletes return to sports at any level, and 89% (n = 185) and 81% (n = 103) returned to their pre-injury level of sports for conservative and surgical approaches, respectively. The time to return to sports was 4.6 and 6.8 months for conservative and surgical approaches, respectively. CONCLUSIONS: Conservative management (bracing, sports modification and physiotherapy) of athletes with spondylolysis show excellent return to sports rates at any level and at the pre-injury level at a mean of 4.6 months. Those who fail the conservative treatment can be successfully managed with surgical treatment with a high rate of return to sports at 6.8 months. LEVEL OF EVIDENCE: Level IV, Systematic review of level IV studies.