Emily A Sweeney, Anastasia Fischer, Madison Brna, Lisa Martin, Jingzhen Yang, Mitchell Selhorst
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引用次数: 0
Abstract
Background: Bony healing rates of spondylolysis on magnetic resonance imaging (MRI) are low, and it is unknown how timing of physical therapy (PT) affects healing.
Hypothesis: It was hypothesized that (1) initiating PT immediately after spondylolysis diagnosis would not have a negative effect on the healing of active lumbar spondylolysis on MRI in adolescent athletes and (2) baseline characteristics, as well as follow-up measures of pain and function, would not be associated with healing on 3-month MRI.
Study design: Randomized controlled trial; Level of evidence, 2.
Methods: This multicenter trial randomized adolescent athletes with lumbar spondylolysis to Immediate PT or Rest Before PT. A blinded radiologist assessed changes in edema and lysis on the initial and 3-month MRIs to determine healing. No rigid bracing was used in any participant.
Results: A total of 53 participants (25 in the Immediate PT group and 28 in the Rest Before PT group) completed a baseline and 3-month follow-up MRI. At 3 months, 81% of participants demonstrated healing on MRI, 8% demonstrated no change, and 11% demonstrated worsened findings. Participants in the Immediate PT group were not more likely to have worse findings on the 3-month MRI than the Rest Before PT group (P = .30). Participants who had healing on 3-month MRI were more likely to be pain-free at that time (97.6% pain-free) than those whose MRI findings did not change or worsened (67% pain-free; P = .01). Participants whose MRI demonstrated healing were less likely to experience a recurrence of pain within 12 months (7.3% recurrence of pain) compared with those whose MRI showed no change or worsened (50% recurrence pain; P = .02).
Conclusion: Prolonged rest may not be necessary to promote healing on MRI in adolescent athletes with lumbar spondylolysis. PT can begin immediately without negatively affecting healing of spondylolysis on MRI.
期刊介绍：
The Orthopaedic Journal of Sports Medicine (OJSM), developed by the American Orthopaedic Society for Sports Medicine (AOSSM), is a global, peer-reviewed, open access journal that combines the interests of researchers and clinical practitioners across orthopaedic sports medicine, arthroscopy, and knee arthroplasty.
Topics include original research in the areas of:
-Orthopaedic Sports Medicine, including surgical and nonsurgical treatment of orthopaedic sports injuries
-Arthroscopic Surgery (Shoulder/Elbow/Wrist/Hip/Knee/Ankle/Foot)
-Relevant translational research
-Sports traumatology/epidemiology
-Knee and shoulder arthroplasty
The OJSM also publishes relevant systematic reviews and meta-analyses.
This journal is a member of the Committee on Publication Ethics (COPE).
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