The Athlete Spine: Pars Fracture in the Young Athlete—When Should We Be Concerned?
The Athlete Spine podcast recently interviewed David Skaggs, MD, executive vice chair of Orthopaedics at Cedars-Sinai and director of Pediatric Orthopaedics at Cedars-Sinai Guerin Children’s, about spondylolysis in young people who play sports.
Spondylolysis—also called pars defect or pars fracture—is a stress fracture, or small crack, in the lower spine that can be caused by excessive wear and tear of physical activity.
Skaggs, co-director of the Cedars-Sinai Spine Center, told podcast hosts Philip Louie, MD, and Venu Nemani, MD, PhD, the condition affects about 6% of the population, causing pain in the lower back when bending forward. But these fractures are not always obvious.
“Most people don’t even know that they have one,” he said, “and [for] most people, it’s not the source of their back pain.”
Skaggs told Louie and Nemani diagnosis and treatment is individualized, and Cedars-Sinai offers various treatment options, including minimally invasive robotic surgery. But sometimes the fracture heals on its own with time.
“You know, parents laugh when I say this, but don’t do anything that hurts,” Skaggs said, noting that imaging scans can be used to pinpoint a diagnosis if pain persists longer than a few weeks. “Use common sense. Give it some time. The human body heals itself.”
Skaggs told Louie and Nemani the best rehabilitation for young athletes with spondylolysis may not involve hours of physical therapy, but instead, much-needed rest followed by a slow return to sports.
“A lot of these kids, they’re not sleeping enough—they have so much going on with homework, et cetera, et cetera, and practice and double sessions,” he said. “You know, we don’t want to throw an extra hour into the day. We want to let them sleep. We want to let them socialize.”
Click here to listen to the entire episode of The Athlete Spine.