Spondylolysis, and Spondylolisthesis Progression Gina Motley, MPT, ATC*; John Nyland, Edd, PT, SCS, Atct; Jake Jacobs, MS, Atct; David N.M
Jounal ofAthletic Training 1998;33(4):351-358 C) by the National Athletic Trainers' Association, Inc www.nata.org/jat The Pars Interarticularis Stress Reaction, Spondylolysis, and Spondylolisthesis Progression Gina Motley, MPT, ATC*; John Nyland, EdD, PT, SCS, ATCt; Jake Jacobs, MS, ATCt; David N.M. Caborn, MDt * Physical Therapy Program, University of Kentucky Center for Rural Health, Hazard, KY; t University of Kentucky, Section of Sports Medicine, Lexington, KY 40502 Objective: To review the classification, etiology, clinical and ment include a thorough evaluation, radiographs (possibly with radiologic evaluation, and management of the pars interarticu- technetium bone scan or single-photon emission computed laris stress reaction, spondylolysis, and spondylolisthesis pro- tomography), activity modification, dietary counseling, a thera- gression. peutic exercise program focusing on proper trunk and hip Data Sources: Grateful Med was searched from 1980 to muscle strength and extensibility balances, and education 1998 using the terms "spondylolysis," "spondylolisthesis," "fe- regarding proper back postures, positioning, lifting mechanics, male athlete," "spondylogenic," and "pars interarticularis." and jump landings. Data Synthesis: The progression from pars interarticularis Conclusions/Recommendations: The athletic trainer plays stress reaction through spondylolysis to spondylolisthesis is an integral part in managing this injury progression, particularly common in adolescent athletes, and, because of hormonal with identifying at-risk individuals and intervening appropri- influences and cheerleading and gymnastic maneuvers, fe- ately. males are particularly at risk. Proper diagnosis and manage- Key Words: low back pain, female athlete, lumbar vertebra B ack pain is one of mankind's greatest afflictions.1 The lumbar spine proper consists of 5 pairs of diarthrodial facet Financial compensation for low back pain in the adult joints, each containing a superior and an inferior facet and a work force has stimulated great interest in its treat- capsule (Figure 1).
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