Management of Lumbar Spondylolysis in Athletes: Role of Imaging

Abstract

Purpose of review

Spondylolysis is a broad term, with advances in imaging enabling more accurate diagnosis of the activity and severity of a lesion. This review discusses the role of different imaging modalities in the diagnosis and management of lumbar spondylolysis in athletes.

Recent Findings

Magnetic resonance imaging (MRI) has diagnostic and practical advantages over other imaging modalities and is particularly useful for detecting early stages of bone stress, including pre-symptomatic screening for active lumbar bone stress injuries. Whilst computed tomography remains the best imaging technique to visualise cortical breaches, specialised MRI sequences offer a viable alternative to detect active bone stress and chronic non-united defects.

Summary

Imaging provides important information for the clinical management of athletes with lumbar spondylolysis. Roles for imaging, in particular MRI, include: (a) proactive screening and early detection, (b) diagnosis of a symptomatic lesion and (c) monitor healing and readiness to return to sport.