Lumbosacral pain in athletes and ballet dancers: spondylolysis and spondylolisthesis

Abstract

Purpose of research. Development of diagnostic algorithm for lumbosacral pain syndrome (PCBS) caused by spondylolysis and spondylolisthesis of I-II degree in athletes and ballet dancers. Material and methods. 212 patients - athletes and entertainers of BA - summer with PCBS caused by spondylolysis (171 persons) and spondylolisthesis of I-II degree (41 persons) of lumbar vertebrae were under observation. Clinical and neurological, x-ray studies, ultrasonography, computed tomography, scintigraphy, as well as the study of markers of bone tissue re - sorption (calcium in urine) and bone formation (alkaline phosphatase) were carried out. Results. Clinical manifestations spondylolysis malespecific (pain after exercise); with the progression of instability and incipient spondylolisthesis pain, strengthening - esja at sharp movements, increased muscle tone of extensors of the back and the rear muscle groups of the thigh. Decisive in the diagnosis are radiological methods. Information content of standard spondylograms is 84.6%, functional-96.7%. To clarify the localization, the size of the arc defect, as well as in subsequent control examinations, an additional study is carried out in 3/4 projections (information content of 99.2%). A highly sensitive informative method is scintigraphy, which allows to determine the presence of bone tissue rearrangement in the first days after the injury. The focus of hyperfixation, or Vice versa, hypothically radiopharmaceutical characteristics would constitute an increase or decrease of metabolic processes. With the help of scintigraphy, you can track the dynamics of reparative processes and determine the timing of the resumption of professional activities. Ultrasonography also helps to detect instability in the vertebral segment in the early stages of its development and monitor the dynamics in the treatment process. Detection of osteopenia evidence of a violation of bone metabolism, which must be considered in the treatment-be sure to use drugs that affect bone metabolism and calcium homeostasis. Conclusion. The combination of standard, functional radiographs, as well as x-rays in oblique projections and scintigraphy is quite adequate for the diagnosis of splondylolysis, spondylolisthesis and the detection of instability in athletes and ballet dancers.