Correlation of Radiographic Healing on Advanced Imaging in Young Adults and Adolescents with Symptomatic Spondylolysis Before and After Treatment: A Retrospective Study

Chase Gauthier; Yianni Bakaes; Haley Puckett; John Dinger; Alec Giakas; Michael Horan

doi:10.1097/BRS.0000000000004976

Correlation of Radiographic Healing on Advanced Imaging in Young Adults and Adolescents with Symptomatic Spondylolysis Before and After Treatment: A Retrospective Study

Spine (Phila Pa 1976). 2024 Feb 29. doi: 10.1097/BRS.0000000000004976. Online ahead of print.

Authors

Chase Gauthier¹, Yianni Bakaes¹, Haley Puckett¹, John Dinger¹, Alec Giakas², Michael Horan¹

Affiliations

¹ Department of Orthopedic Surgery, Prisma Health, Columbia, SC, USA.
² Department of Orthopedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USA.

PMID: 38420702
DOI: 10.1097/BRS.0000000000004976

Abstract

Study design: Retrospective chart-review.

Objective: To determine the effect of conservative measures on radiographic outcomes in those with isolated spondylosis.

Summary of background data: Spondylosis 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 spondylosis and are effective in controlling symptoms, but there is little evidence regarding their effect on radiographic outcomes.

Methods: A retrospective review was conducted of patients diagnosed with spondylosis who were treated at a single academic institution between January 1st, 2012, and January 1st, 2022. Data collected included demographics, presentation characteristics, pre- and post-treatment radiologic findings, types of treatments employed, and final symptomatic status at follow-up. The student's t-test and the Wilcoxon rank sum test were used to compare continuous variables. The Chi-Squared test was used to compare categorical variables.

Results: 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 to 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 to those who did not.

Conclusion: Our study found those with isolated spondylosis 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 to those without.

Level of evidence: IV.