Characteristics of Adult-Onset Acute Lumbar Spondylolysis Treated Conservatively
Introduction: Lumbar spondylolysis typically arises during adolescence, whereas its onset in adulthood is rare. Several studies have reported incidentally identified terminal-stage spondylolysis in adults, but only one case series has investigated acute lumbar spondylolysis lesions with bone marrow...
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| Format: | Article |
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The Japanese Society for Spine Surgery and Related Research
2023-01-01
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| Series: | Spine Surgery and Related Research |
| Subjects: | |
| Online Access: | https://www.jstage.jst.go.jp/article/ssrr/7/1/7_2022-0099/_pdf/-char/en |
| _version_ | 1797924728392908800 |
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| author | Reo Asai Masaki Tatsumura Shun Okuwaki Hisanori Gamada Toru Funayama Atsushi Hirano Masashi Yamazaki |
| author_facet | Reo Asai Masaki Tatsumura Shun Okuwaki Hisanori Gamada Toru Funayama Atsushi Hirano Masashi Yamazaki |
| author_sort | Reo Asai |
| collection | DOAJ |
| description | Introduction: Lumbar spondylolysis typically arises during adolescence, whereas its onset in adulthood is rare. Several studies have reported incidentally identified terminal-stage spondylolysis in adults, but only one case series has investigated acute lumbar spondylolysis lesions with bone marrow edema in adults.
Methods: We retrospectively investigated lumbar spondylolysis in patients aged 18 years or older. Age at diagnosis, sex, competitive sporting level, and competitive sporting discipline were investigated in each patient. The level of the affected vertebra, pathological stage, bone union, and treatment period were analyzed for each lesion.
Results: The study included nine patients (eight males and one female), aged 18-22 years old, with 14 acute lumbar spondylolysis lesions. Four patients were soccer players (two professionals, and two amateurs), four were amateur track and field athletes, and one was an amateur basketball player. The affected vertebral levels were L3 in two lesions, L4 in seven lesions, and L5 in five lesions. The pathological stage was pre-lysis stage in two lesions, early stage in eight lesions, and progressive stage in four lesions. Ten lesions achieved bone union with conservative therapy. The average treatment period was 84.7 days.
Conclusions: The adult-onset lumbar spondylolysis patients were young, up to their early 20s, and generally professional sportspeople performing at an elite level. Most of them were performing a sport that has been reported to have a high risk of causing lumbar spondylolysis. L4 was the most affected vertebral level in contrast to L5, which has been reported in adolescent lumbar spondylolysis. Bone union was achieved for most lesions with conservative therapy. |
| first_indexed | 2024-04-10T15:05:44Z |
| format | Article |
| id | doaj.art-c384d2ca85b344aaa565d2e73b27097f |
| institution | Directory Open Access Journal |
| issn | 2432-261X |
| language | English |
| last_indexed | 2024-04-10T15:05:44Z |
| publishDate | 2023-01-01 |
| publisher | The Japanese Society for Spine Surgery and Related Research |
| record_format | Article |
| series | Spine Surgery and Related Research |
| spelling | doaj.art-c384d2ca85b344aaa565d2e73b27097f2023-02-15T05:02:36ZengThe Japanese Society for Spine Surgery and Related ResearchSpine Surgery and Related Research2432-261X2023-01-0171838810.22603/ssrr.2022-00992022-0099Characteristics of Adult-Onset Acute Lumbar Spondylolysis Treated ConservativelyReo Asai0Masaki Tatsumura1Shun Okuwaki2Hisanori Gamada3Toru Funayama4Atsushi Hirano5Masashi Yamazaki6Department of Medical Education and Training, Tsukuba Medical Center HospitalDepartment of Orthopaedic Surgery and Sports Medicine, Tsukuba University Hospital Mito Clinical Education and Training Center, Mito Kyodo General HospitalDepartment of Orthopaedic Surgery, Faculty of Medicine, University of TsukubaDepartment of Orthopaedic Surgery, Faculty of Medicine, University of TsukubaDepartment of Orthopaedic Surgery and Sports Medicine, Tsukuba University Hospital Mito Clinical Education and Training Center, Mito Kyodo General HospitalDepartment of Orthopaedic Surgery and Sports Medicine, Tsukuba University Hospital Mito Clinical Education and Training Center, Mito Kyodo General HospitalDepartment of Orthopaedic Surgery, Faculty of Medicine, University of TsukubaIntroduction: Lumbar spondylolysis typically arises during adolescence, whereas its onset in adulthood is rare. Several studies have reported incidentally identified terminal-stage spondylolysis in adults, but only one case series has investigated acute lumbar spondylolysis lesions with bone marrow edema in adults. Methods: We retrospectively investigated lumbar spondylolysis in patients aged 18 years or older. Age at diagnosis, sex, competitive sporting level, and competitive sporting discipline were investigated in each patient. The level of the affected vertebra, pathological stage, bone union, and treatment period were analyzed for each lesion. Results: The study included nine patients (eight males and one female), aged 18-22 years old, with 14 acute lumbar spondylolysis lesions. Four patients were soccer players (two professionals, and two amateurs), four were amateur track and field athletes, and one was an amateur basketball player. The affected vertebral levels were L3 in two lesions, L4 in seven lesions, and L5 in five lesions. The pathological stage was pre-lysis stage in two lesions, early stage in eight lesions, and progressive stage in four lesions. Ten lesions achieved bone union with conservative therapy. The average treatment period was 84.7 days. Conclusions: The adult-onset lumbar spondylolysis patients were young, up to their early 20s, and generally professional sportspeople performing at an elite level. Most of them were performing a sport that has been reported to have a high risk of causing lumbar spondylolysis. L4 was the most affected vertebral level in contrast to L5, which has been reported in adolescent lumbar spondylolysis. Bone union was achieved for most lesions with conservative therapy.https://www.jstage.jst.go.jp/article/ssrr/7/1/7_2022-0099/_pdf/-char/enlumbar spondylolysisadult-onsetacutebone marrow edemaconservative therapybone union rate |
| spellingShingle | Reo Asai Masaki Tatsumura Shun Okuwaki Hisanori Gamada Toru Funayama Atsushi Hirano Masashi Yamazaki Characteristics of Adult-Onset Acute Lumbar Spondylolysis Treated Conservatively Spine Surgery and Related Research lumbar spondylolysis adult-onset acute bone marrow edema conservative therapy bone union rate |
| title | Characteristics of Adult-Onset Acute Lumbar Spondylolysis Treated Conservatively |
| title_full | Characteristics of Adult-Onset Acute Lumbar Spondylolysis Treated Conservatively |
| title_fullStr | Characteristics of Adult-Onset Acute Lumbar Spondylolysis Treated Conservatively |
| title_full_unstemmed | Characteristics of Adult-Onset Acute Lumbar Spondylolysis Treated Conservatively |
| title_short | Characteristics of Adult-Onset Acute Lumbar Spondylolysis Treated Conservatively |
| title_sort | characteristics of adult onset acute lumbar spondylolysis treated conservatively |
| topic | lumbar spondylolysis adult-onset acute bone marrow edema conservative therapy bone union rate |
| url | https://www.jstage.jst.go.jp/article/ssrr/7/1/7_2022-0099/_pdf/-char/en |
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