Department of Orthopedic Surgery, Prisma Health, Columbia, SC.
Department of Orthopedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA.
Spine (Phila Pa 1976). 2024 Sep 1;49(17):1203-1209. doi: 10.1097/BRS.0000000000004976. Epub 2024 Feb 29.
Retrospective chart review.
To determine the effect of conservative measures on radiographic outcomes in those with isolated spondylolysis.
Spondylolysis is a common cause of low back pain in pediatric patients, affecting between 4.4% and 4.7% of all pediatric patients. This rate is even higher in high-level athletes, with recent studies suggesting a rate of 47% in this population. Conservative measures are recommended for treating symptomatic spondylolysis and are effective in controlling symptoms, but there is little evidence regarding their effect on radiographic outcomes.
A retrospective review was conducted of patients diagnosed with spondylolysis who were treated at a single academic institution between January 1, 2012, and January 1, 2022. Data collected included demographics, presentation characteristics, pretreatment and post-treatment radiologic findings, types of treatments employed, and final symptomatic status at follow-up. The Student t test and the Wilcoxon rank sum test were used to compare continuous variables. The χ 2 test was used to compare categorical variables.
A total of 119 patients were included in the study. There was an 81.5% rate of healing on advanced imaging for those treated with conservative measures. When comparing those with healing on advanced imaging to those without, those with healing were more likely to have an acute fracture ( P= 0.04), have symptomatic improvement ( P <0.01), and return-to-play ( P= 0.02) compared with those without. Those with healing also had an odds ratio of 6.9 ( P <0.01) and 4.5 ( P =0.02) to achieve symptomatic improvement and return to their sport, respectively, compared with those who did not.
Our study found those with isolated spondylolysis who were treated with conservative measures had a high healing rate on advanced imaging and those with healing had significantly higher odds of having symptomatic improvement and returning to play compared with those without.
回顾性图表审查。
确定保守治疗对孤立性脊椎裂患者影像学结果的影响。
脊椎裂是儿童腰痛的常见原因，影响所有儿童患者的 4.4%至 4.7%。在高水平运动员中，这个比例甚至更高，最近的研究表明，该人群中有 47%的人患有脊椎裂。保守治疗是治疗症状性脊椎裂的推荐方法，对控制症状有效，但关于其对影像学结果的影响的证据很少。
对 2012 年 1 月 1 日至 2022 年 1 月 1 日在一家学术机构接受治疗的诊断为脊椎裂的患者进行了回顾性审查。收集的数据包括人口统计学、表现特征、治疗前和治疗后影像学发现、采用的治疗类型以及随访时的最终症状状态。使用学生 t 检验和 Wilcoxon 秩和检验比较连续变量。使用 χ 2 检验比较分类变量。
共有 119 名患者纳入研究。接受保守治疗的患者在高级影像学上的愈合率为 81.5%。在比较影像学上愈合的患者和未愈合的患者时，愈合的患者更有可能出现急性骨折（P=0.04）、症状改善（P<0.01）和重返赛场（P=0.02），而未愈合的患者则没有。与未愈合的患者相比，愈合的患者在症状改善（P<0.01）和重返运动（P=0.02）方面的优势比分别为 6.9（P<0.01）和 4.5（P=0.02）。
我们的研究发现，接受保守治疗的孤立性脊椎裂患者在高级影像学上有很高的愈合率，且与未愈合的患者相比，愈合的患者在症状改善和重返运动方面的可能性显著更高。
4 级。
