SPORTS MEDICINE Conservative treatment of lumbar spondylolysis in young soccer players Pedro A ´ lvarez-Dı ´az • Eduard Alentorn-Geli • Gilbert Steinbacher • Marta Rius • Ferran Pellise ´ • Ramo ´n Cugat Received: 5 October 2010 / Accepted: 8 February 2011 / Published online: 4 May 2011 Ó Springer-Verlag 2011 Abstract Purpose The purpose of this study was to report the functional outcomes of young active soccer players with lumbar spondylolysis undergoing conservative treatment. Methods Between 2002 and 2004, all soccer players diagnosed with spondylolysis with a minimum 2-year fol- low-up were retrospectively reviewed. All patients were treated nonoperatively with cessation of sports activity and rehabilitation for 3 months. The rehabilitation protocol was identical for all patients and emphasized strengthening of abdominal muscles, stretching of the hamstrings, ‘‘core’’ stability exercises, and trunk rotational movements in a pain-free basis. Those patients with pain at rest and with daily life activities were also treated with a thoracolumbar orthosis. Symptomatic patients or those with positive SPECT were not allowed to return to sports and continued the rehabilitation protocol for 3 more months. Results The mean time of cessation of sports activity was 3.9 months (SD 0.8) and 5.2 months (SD 2.1) for a com- plete return to sports. At the 2-year follow-up, 28 patients (82%) obtained excellent results, 4 (12%) good results, 1 patient (3%) a fair result, and 1 patient (3%) a poor result. Conclusions Conservative treatment of spondylolysis in young soccer players with cessation of sports and reha- bilitation, with or without thoracolumbar orthosis, was associated with excellent functional results in terms of return to sports and level of achievable physical activity. Level of evidence Case series, Level IV. Keywords Lumbar spondylolysis Á Conservative treatment Á Rehabilitation Á Soccer players Introduction Soccer is the most commonly played sport in the world, with an estimated 265 million active soccer players by 2006 [7]. The rising popularity of this sport has evoked in an increase in the number of injuries [18]. Spine disorders are one of the most common soccer injuries [17]. Spon- dylolysis is a very common cause of low back pain in young athletes [8]. In fact, spondylolysis may approxi- mately explain 47% of cases of low back pain in patients younger than 18 compared to a 5% of cases in patients over 21 years old [11]. Lumbar flexion–extension movements, trunk rotations, lumbar compression forces at landing, and an increased sacro-horizontal angle have been reported as predisposing factors for lumbar spondylolysis [5, 6, 20]. Despite the high frequency of lumbar spondylolysis in young soccer players, there is a clear lack of data regarding the functional outcomes and the return to sports criteria after conservative treatment. The purpose of this study was to report the functional outcomes of young active soccer players with lumbar spondylolysis undergoing conservative treatment with ces- sation of sports and rehabilitation with or without thoraco- lumbar orthosis. It was hypothesized that conservative P. A ´ lvarez-Dı ´az Á E. Alentorn-Geli Á G. Steinbacher Á M. Rius Á R. Cugat Mutualitat Catalana de Futbolistes–Delegacio ´ Catalunya, Ronda Sant Pere 19–21, 08010 Barcelona, Spain P. A ´ lvarez-Dı ´az Á E. Alentorn-Geli Á F. Pellise ´ Á R. Cugat (&) Department of Orthopedic Surgery, Hospital Quiro ´n, Plac ¸a Alfonso Comı ´n 5–7, 08023 Barcelona, Spain e-mail: ramon.cugat@sportrauma.com P. A ´ lvarez-Dı ´az Á E. Alentorn-Geli Á R. Cugat Garcia-Cugat Foundation, Calle Madrazo 43, 08006 Barcelona, Spain 123 Knee Surg Sports Traumatol Arthrosc (2011) 19:2111–2114 DOI 10.1007/s00167-011-1447-7