Department of Orthopaedic Surgery, University of Virginia, PO Box 800159, Charlottesville, VA 22908, USA.
Department of Orthopaedic Surgery, University of Virginia, PO Box 800159, Charlottesville, VA 22908, USA.
Clin Sports Med. 2021 Jul;40(3):471-490. doi: 10.1016/j.csm.2021.03.004.
Repetitive stress on the lumbosacral spine during sporting activity places the athletic patient at risk of developing symptomatic pars defect. Clinical history, physical examination, and diagnostic imaging are important to distinguish spondylolysis from other causes of lower back pain. Early pars stress reaction can be identified with advanced imaging, before the development of cortical fracture or vertebral slip progression to spondylolisthesis. Conservative management is first-line for low-grade injury with surgical intervention indicated for refractory symptoms, severe spondylolisthesis, or considerable neurologic deficit. Prompt diagnosis and management of spondylolysis leads to good outcomes and return to competition for most athletes.
在运动过程中，腰骶脊柱的反复劳损会使运动员患者有发生症状性峡部裂的风险。临床病史、体格检查和诊断性影像学检查对于区分峡部裂与其他腰痛病因非常重要。通过先进的影像学检查，可以在皮质骨折或椎体滑脱进展为脊椎滑脱之前，早期发现峡部应力反应。对于低级别损伤，首先采用保守治疗，对于难治性症状、严重脊椎滑脱或明显神经功能缺损，则需要手术干预。对于大多数运动员来说，及时诊断和治疗峡部裂可获得良好的结果并恢复比赛。
