Low-Intensity Pulsed Ultrasound for Early-Stage Lumbar Spondylolysis in Young Athletes

Objective: To examine the effect of low-intensity pulsed ultrasound (LIPUS) on early-stage spondylolysis in young athletes. Design: Case–control study. Setting: A single outpatient orthopedic and sports clinic. Patients: A total of 82 young athletes (80 boys and 2 girls; mean age, 14.8 years; range, 10-18 years) with early-stage lumbar spondylolysis were enrolled in this study. All patients were examined by plain radiography and magnetic resonance imaging. Interventions: Patients received either standard conservative treatment combined with LIPUS (n = 35) or without LIPUS (n = 47), according to the sequence of admission. The standard conservative treatment included thoracolumbosacral brace, sports modification, and therapeutic exercise. Main Outcome Measures: The time required to return to previous sports activities was analyzed by using Kaplan–Meier methods with the log-rank test. Results: The baseline parameters of both groups were not significantly different. The median time to return to previous sports activities was 61 days [95% confidence interval (CI): 58-69 days] in the group treated with LIPUS, which was significantly shorter than that of the group treated without LIPUS (167 days, 95% CI: 135-263 days; P
Source: Clinical Journal of Sport Medicine - Category: Sports Medicine Tags: Original Research Source Type: research

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Conclusions: The sports with the greatest risk of spondylolysis in adolescent athletes in this study were not consistent with published literature. Clinicians should be cautious generalizing high-risk sports to their practice, as geographic region and level of the athlete may significantly influence the incidence of spondylolysis in the population they are treating.
Source: Clinical Journal of Sport Medicine - Category: Sports Medicine Tags: Original Research Source Type: research
Authors: Selby MS, Gillette A, Raval Y, Taufiq M, Sampson MJ Abstract Modern human bipedality is unique and requires lumbar lordosis, whereas chimpanzees, our closest relatives, have short lumbar spines rendering them incapable of lordosis. To facilitate lordosis, humans have longer lumbar spines, greater lumbosacral angle, dorsally wedged lumbar vertebral bodies, and lumbar zygapophyseal joints with both increasingly coronal orientation and further caudal interfacet distances. These features limit modern lower lumbar spine and lumbosacral joint ailments, albeit imperfectly. The more coronal zygapophyseal orientati...
Source: Journal of the American Osteopathic Association - Category: Complementary Medicine Tags: J Am Osteopath Assoc Source Type: research
Study Design. A cross-sectional, retrospective cohort study. Objective. To examine the prevalence of the pedicle stress injury, spondylolysis in children and adolescents with low back pain. And secondly, to test the hypothesis that these pathologies are associated with lumbar lordosis angle. Summary of Background Data. The prevalence of the pedicle stress injury has not been investigated in children with low back pain. In recent studies, lumbar lordosis angle was associated with spondylolysis, on the other hand the pedicle stress injury was not investigated yet. Methods. In this retrospective study, 789 consecut...
Source: Spine - Category: Orthopaedics Tags: DIAGNOSTICS Source Type: research
Authors: Yamamoto S, Iwamuro M, Miyake M, Nishimura N, Mizuno M, Okada H Abstract A 49-year-old man with diabetes taking clopidogrel and celecoxib underwent interbody fusion surgery for spinal spondylolysis. Ten days after the surgery, he vomited a large amount of fresh blood. A blood examination revealed hemodynamic failure. Esophagogastroduodenoscopy showed an adherent blood clot and multiple superficial ulcers in the esophagus. Endoscopic hemostasis was successfully achieved. Biopsy specimens from the esophageal ulcer showed positive immunohistochemical staining results for anti-CMV antibodies. The esophageal ul...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
AbstractPurpose of ReviewThis paper aims to review anatomic and pathology-specific sex differences of the spine.Recent FindingsWhile cadaveric and imaging analyses have shown differences in planar orientation of vertebral anatomy and alignment, the data is less conclusive for clinically correlating these differences. Reports show that predilection to injury in athletes is influenced by both gender and the nature of the sport, which makes it difficult to determine the exact contribution of sex differences to injury rates. Multiple articles report an increased incidence of spondylolysis, disc degeneration, and ankylosing spo...
Source: Current Physical Medicine and Rehabilitation Reports - Category: Rehabilitation Source Type: research
Authors: Desai N, Vance DD, Rosenwasser MP, Ahmad CS Abstract Artistic gymnastics is a physically demanding sport that requires flexibility, agility, and extreme upper and lower body strength. The specific biomechanics of the sport leads to a unique injury profile. Gymnastic skills require intense upper body weight-bearing, placing unusual forces across the upper extremity joints and predisposing them to injury. In addition, the required body control during air aerobatics (tumbling, twisting, flipping) necessitates precise landing techniques to avoid spine and lower extremity injury. Common gymnastic injuries inclu...
Source: The Journal of the American Academy of Orthopaedic Surgeons - Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research
Discussion: An abnormal neurological examination was found as a strong predictor for an underlying pathologic condition. Further imaging of a pediatric patient with back pain without clear explanation for their symptoms on plain radiographs should not be limited to constant pain, or night pain because clinicians could be missing important diagnosis. Therefore, the clinician cannot be assured by absence of these clinical markers, that there is no underlying spinal pathology. Level of Evidence: Level III.
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Selected Topics Source Type: research
The proposed pathology-free lumbosacral unit model showed good correlation with experimental tests for all loading cases. In unilateral spondylolysis, a subsequent pars defect was observed within the same vertebra. The overall modeling approach can be used to study different pathological states.
Source: Clinical Biomechanics - Category: Orthopaedics Authors: Source Type: research
Authors: Campos M, Vial R, Castro J, Urrutia J Abstract High-intensity zone is an area of high-intensity signal within the posterior annulus fibrosus observed in magnetic resonance imaging; initially described in painful discs, recent studies have described similar prevalence in symptomatic and asymptomatic subjects. Since its' prevalence in the general population has not been established, we used a screening tool independent of spinal symptoms to determine high-intensity zone prevalence. We studied 217 patients evaluated with abdominal-pelvic magnetic resonance imaging; we looked for high-intensity zone, disc dege...
Source: Acta Orthopaedica Belgica - Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research
HISTORY OF DEGENERATIVE SPONDYLOLISTHESIS: FROM ANATOMICAL DESCRIPTION TO SURGICAL MANAGEMENT. Neurochirurgie. 2019 Apr 02;: Authors: Bernard F, Mazerand E, Gallet C, Troude L, Fuentes S Abstract This review of the historical medical literature aimed at understanding the evolution of surgical management of degenerative spondylolisthesis over time. The Medic@, IndexCat and Gallica historical data-bases and PubMed and Embase medical data-bases were used, with several search-terms, exploring the years 1700-2018. Data from anatomical, biomechanical, pathophysiological and surgical studies were compiled. 1...
Source: Neuro-Chirurgie - Category: Neurosurgery Authors: Tags: Neurochirurgie Source Type: research
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