Direct repair of spondylolytic defects in young competitive athletes

Abstract

Background context: Operative treatment of symptomatic spondylolysis is rare. A variety of surgeries have been described. In general, reported operative success rates are high, although in most studies the successful return to sport of the competitive athlete is not detailed. Purpose: To review outcome, specifically return to sport, in a group of competitive athletes after direct pars repair for symptomatic spondylolysis. Study design/setting: This was a retrospective case series of a single surgeon. Patient sample: Series of four athletes who underwent direct pars repair over an 18-month period. Outcome measures: Return to their sport. Methods: Chart review of all patients who had undergone a single-level pars repair over an 18-month period. All patients had normal discs above the level of the repair. Postoperative clinical course was determined for all patients. Results: The patients participated in different sports. All were able to return to their presymptomatic level of activity with no restriction. One had periodic low back pain that required nonsteroidal anti-inflammatory medicine as needed. The others were entirely asymptomatic. Conclusions: This small series suggests that with specific inclusion criteria, a select group of motivated athletes can expect to return to their sport after direct pars repairs for symptomatic spondylolysis that has failed conservative treatment.