Spondylolysis: Assessment and Treatment in Youth Athletes

Lauren F. Vernese*, Samuel K. Chu

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations


Purpose of Review: Spondylolysis is a defect in the pars interarticularis that can range from a stress reaction to an overt fracture. It is the most common cause of low back pain in adolescent athletes, with a higher incidence in sports involving repetitive hyperextension. The purpose of this review is to discuss the work-up and management of spondylolysis in the youth athlete. Recent Findings: A thorough history and physical examination is important in the evaluation of a patient with suspected spondylolysis, but there is no one examination maneuver with high sensitivity and specificity. Although plain radiography is the first imaging study ordered, it is frequently non-diagnostic and generally requires follow-up bone scan, CT, or MRI. The use of bracing appears to have improved short-term relief of pain but similar long-term outcomes when compared to conservative management without bracing. If pain persists despite 6–9 months of conservative management, surgery is an option and has excellent outcomes. Summary: In this review article, aspects of the history that can assist in making a diagnosis are explored. Imaging options are also discussed to help the physician order the most efficacious test for each patient. Conservative management options are reviewed, along with a brief discussion of surgical management. Overall, the current literature suggests an excellent outcome with return to previous sport for most young athletes with spondylolysis.

Original languageEnglish (US)
Pages (from-to)75-82
Number of pages8
JournalCurrent Physical Medicine and Rehabilitation Reports
Issue number2
StatePublished - Jun 1 2017


  • Adolescent
  • Low back pain
  • Pars fracture
  • Spondylolysis
  • Youth athlete

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation
  • Orthopedics and Sports Medicine
  • Medicine (miscellaneous)


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