ArticleBMC musculoskeletal disorders2025
Comparative outcomes of motion-preserving techniques for lumbar spondylolysis in young athletes.
Article in BMC musculoskeletal disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND AND
objectiveSymptomatic lumbar spondylolysis often disables young athletes. We compared three motion-preserving techniques-modified Scott (MST), pedicle screw system (PSS), and dual-stability construct (DSC)-for pars healing and functional recovery.
methodsWe retrospectively reviewed 103 active adults (18-40 years) with L3/L4/L5 spondylolysis treated at a single centre between 2017 and 2023. Patients were allocated to modified Scott (MST, n = 33), pedicle-screw (PSS, n = 27) or dual-stability construct (DSC, n = 43). All underwent isthmic debridement, autologous grafting and identical rehabilitation. CT (computed tomography) evaluated pars healing; VAS (Visual Analogue Scale) and JOA-L (Japanese Orthopaedic Association) scores, complications and Magnetic resonance imaging (MRI) Pfirrmann grading were recorded.
resultsAt 17.5 ± 6.5 months, DSC achieved the highest healing rate (95.3%) versus PSS (88.9%) and MST (60.6%) (P < 0.001). DSC and PSS were independent predictors of healing (Risk ratios (RR) 12.9 and 4.6 vs. MST). JOA improvement was greatest with DSC (80.53%) and PSS (79.89%) versus MST (67.74%). MST exhibited 12% implant failure (spinous cut-through). No adjacent-disc degeneration was observed in PSS or DSC, supporting short-term motion preservation. CT type II/III defects and overweight status predicted non-union.
conclusionPSS and DSC offer significant advantages over MST for treating symptomatic lumbar spondylolysis in young active adults, with DSC yielding the most favorable outcomes. The dual-stability construct, integrating intra- and intersegmental fixation, enhances pars healing and maintains disc health, supporting its use as a motion-preserving and biomechanically robust technique. These findings may guide surgical decision-making and contribute to improved recovery and functional restoration in athletic youth.
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