title: Benign Natural History of Spondylolysis in Adolescence With Midterm Follow-Up.
abstract: Retrospective chart review.
  
  
  
  To use the Micheli Functional Scale to assess adolescent patients with spondylolysis treated conservatively at midterm follow-up.
  
  
  
  Spondylolysis is a common source of back pain for adolescents and is generally managed with bracing and physical therapy. There is little data regarding the results of conservative management of spondylolysis over time.
  
  
  
  Four major academic pediatric institutions performed a retrospective chart review of patients from 5 to 21 years of age with the initial diagnosis of spondylolysis. Inclusion criteria were patients who initially underwent conservative management and had a minimum of 2 years' follow-up. The patients were contacted and asked to complete the Micheli Functional Scale Survey.
  
  
  
  A total of 295 patients with the diagnosis of spondylolysis were identified and contacted. Sixty-one subjects with spondylolysis completed the follow-up survey. Sixty of 61 respondents (98%) answered questions regarding their current pain level. Thirty-five of 60 (58.3%) reported no pain (0/10) and 47/60 (78%) rated their pain at 3 or less, whereas 22% (13/60) rated their pain as 4 or higher. There was no correlation with pain ratings on the follow-up survey and radiographic healing at initial management. Of the 61 patients, 50 returned to sports (82%), 8 did not return (13%), and 5 returned to most but not all of their sports (8%). No correlation was observed between radiographic healing and return to sports (p = .4885).
  
  
  
  Using a validated functional scale, this study demonstrated that with conservative management of spondylolysis a majority of patients at an average of 8 years out self-report a return to sports (90%), though many reported continued pain (42%) and interference with activities (67%). There was no correlation observed between radiographic evidence of healing and pain or return to sports with a mean follow-up of 8 years.
  
  
  
  Multicenter retrospective case series.
authors.affiliation: Children's Orthopaedic Center, Children's Hospital Los Angeles, 4650 Sunset Blvd., Mailstop #69, Los Angeles, CA 90027, USA.
authors.forename: Ted
authors.initials: T
authors.lastname: Sousa
authors.affiliation: Children's Orthopaedic Center, Children's Hospital Los Angeles, 4650 Sunset Blvd., Mailstop #69, Los Angeles, CA 90027, USA. Electronic address: dskaggs@chla.usc.edu.
authors.forename: David L
authors.initials: DL
authors.lastname: Skaggs
authors.affiliation: Children's Orthopaedic Center, Children's Hospital Los Angeles, 4650 Sunset Blvd., Mailstop #69, Los Angeles, CA 90027, USA.
authors.forename: Priscella
authors.initials: P
authors.lastname: Chan
authors.affiliation: Department of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, CA 90095, USA.
authors.forename: Kent T
authors.initials: KT
authors.lastname: Yamaguchi
authors.affiliation: Department of Orthopaedic Surgery, University of Tennessee-Campbell Clinic, Memphis, TN 38104, USA.
authors.forename: Jerald
authors.initials: J
authors.lastname: Borgella
authors.affiliation: Department of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, CA 90095, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, University of Tennessee-Campbell Clinic, Memphis, TN 38104, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Sawyer
authors.affiliation: LeBonheur Children's Hospital, 51 N Dunlap St #100, Memphis, TN 38105, USA.
authors.forename: Alice
authors.initials: A
authors.lastname: Moisan
authors.affiliation: Division of Orthopaedic Surgery, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA.
authors.forename: John M
authors.initials: JM
authors.lastname: Flynn
authors.affiliation: Division of Orthopaedic Surgery, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Gunderson
authors.affiliation: Division of Sports Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115, USA.
authors.forename: M Timothy
authors.initials: MT
authors.lastname: Hresko
authors.affiliation: Division of Sports Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115, USA.
authors.forename: Pierre
authors.initials: P
authors.lastname: D'Hemecourt
authors.affiliation: Children's Orthopaedic Center, Children's Hospital Los Angeles, 4650 Sunset Blvd., Mailstop #69, Los Angeles, CA 90027, USA.
authors.forename: Lindsay M
authors.initials: LM
authors.lastname: Andras
mesh_terms: D000293:Adolescent; D001416:Back Pain / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D000072700:Conservative Treatment / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011859:Radiography / Q000379:methods / Q000706:statistics & numerical data; D012189:Retrospective Studies; D000068958:Return to Sport / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D013169:Spondylolysis / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Adolescent; Conservative; Nonoperative; Radiology; Spondylolysis