Lumbosacral pain in athletes and ballet dancers: spondylolysis and spondylolisthesis. Conservative treatment

Abstract

The aim of the study was to develop an algorithm for conservative treatment of lumbosacral pain syndrome (PCBS) caused by spondylolysis in athletes and ballet dancers. Materials and methods. The study included 212 patients athletes and ballet dancers with PCBS caused by spondylolysis (171 people) and grade III spondylolisthesis (41 people) of the lumbar vertebrae. Clinical, neurological, and X-ray studies, ultrasonography, computed tomography, scintigraphy, functional testing, as well as markers of bone resorption (calcium in urine) and bone formation (alkaline phosphatase) were performed. Results. All patients underwent conservative treatment: functional therapy, physiotherapy, ozone and drug therapy. Functional rehabilitation treatment included three stages: 1 relief of pain; 2 restoration of support ability and stability of the spine; 3 restoration of special motor skills. As a result of treatment, the functional parameters of the muscles stabilizing the spine improved (tone, contractile activity, bioelectric parameters), and the muscle imbalance was eliminated. After treatment, in radiographs, in most cases, a defect was observed in the arch of the vertebra, but it was much smaller in width and did not affect professional performance. Complete restoration of the bone structure in the area of the arc defect was observed only with acute pathology, complete cessation of sports load and a long (1 year or more) sparing regimen (9 people). Excellent and good results were obtained in 171 (80.7%) patients, satisfactory in 36 (16.9%) patients. Five (2.4%) patients with spondylolisthesis were not able to continue their professional activities, the result of conservative treatment was regarded as unsatisfactory. Three of them were subsequently underwent surgical treatment. Conclusion. The development of an individual program of conservative rehabilitation treatment for athletes and ballet dancers with spondylolysis and grade I and II spondylolisthesis, adequate and timely use of rehabilitation features lead to eliminating muscle imbalance and strengthening muscle corset. This, in turn, will contribute to the relief of pain, restoration of professional performance, prevention of progression of the area of bone reconstruction of the vertebral arches and spondylolisthesis