Abstract des Autors

The objective of this article is to present a case of spondylolysis in an adolescent athlete and discuss the clinical manifestations and diagnostic protocol. An adolescent soccer player with unremitting lower back pain presented to a chiropractor's office for evaluation and treatment. He had successful chiropractic treatment in the past. After a series of unsuccessful chiropractic manipulative therapies, he was evaluated by an orthopedist. The orthopedist's diagnosis was lumbar sprain strain in the light of negative radiographs of the lumbar spine. He was eventually evaluated by a second and third orthopedist and underwent a series of diagnostic tests including magnetic resonance imaging, computed tomographic scanning, and single photon emission computed tomography (SPECT) imaging. SPECT imaging confirmed the presence of unilateral spondylolysis at L5. Treatment included bracing with a modified Boston brace, rest, and specific exercises. The condition responded extremely well. This is verified by the follow-up SPECT scan taken after 7 months, which revealed a significantly decreased uptake. This case is presented to show the importance of diagnostic procedures, specifically SPECT scans, to diagnose spondylolysis in adolescent athletes in the absence of positive radioraphic findings. It is also intended to make the chiropractor who treats these athletes aware of the use of bracing in the treatment of spondylolysis in adolescent athletes. Verf.-Referat