P38. Spondylolysis in athletic children, how many hours of training a week is too much?

Abstract

BACKGROUND CONTEXT Many risk factors for spondylolysis have been described in the pediatric population literature. The type of sport has always been cited as one of the most important factors, followed by the start age of training, posterior arch dysplasia, high pelvic incidence and sacral slope. PURPOSE To investigate if the type of athletic activity, age, sex, training hours a week and radiological anomalies are risk factors in the pathogenesis of spondylolysis. STUDY DESIGN/SETTING Prospective cohort study. PATIENT SAMPLE We prospectively studied the athletic pediatric population with back pain in one center dedicated to sports injuries over the course of one year. Inclusion criteria: under 25 years old, active competitive sports, back or radicular pain, diagnosis with CT-Scan, MRI, lumbar and dynamic flexion/extension X-rays. Exclusion criteria: previous diagnosis of any lumbar pathology or treatment. OUTCOME MEASURES Presence of lysis, number of levels with lysis, unilateral or bilateral involvement, presence of listhesis. METHODS Patients were queried about the type of sport practiced, and number of hours of competitive training per week. Images were analyzed to determine the presence of radiologic anomalies; pedicle and lamina width were measured on CT scan. Pearson 2-tailed correlations were used to assess associations between the collected parameters and the listhesis characteristics. RESULTS A total of 37 patients (23M, 17.27 yo) were included. The most frequent sports were soccer, weightlifting, and artistic gymnastics; 6 patients practiced two different disciplines. Of the total, 89.3% had one level lysis, of which 78.6% were at L5. Of the 10.7% with double levels lysis, 83% were at L4-L5, one was at L3-L4. The lysis was bilateral for 44.4% of the patients, on the left for 37%, and on the right for 18.5%. Radiographic anomalies were present in 24% of patients, mainly at a transitional level. There was no correlation between sex, age, number of training hours, type of sport, lamina and pedicle width and/or any other radiographic anomalies with level, side, number of lysis levels and/or listhesis severity (all greater that 0.05). CONCLUSIONS Age, sex, number of training hours, type of sport, width of the pedicle or lamina, and radiographic anomalies do not correlate with the characteristics of lysis in athletic pediatric population with back pain. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.