Centro de la columna Vertebral: January 21, 2016
Spondylosis refers to a defect within the vertebra, at the back of the neural arch, in the interarticular pars, the level most affected being L5 (85 to 95% of cases), followed by L4 (5 to 15% of cases).
The mechanism of production itself is unknown, although it is accepted that it is a fatigue fracture caused by repetitive loading mechanisms.
Its prevalence in the general population ranges approximately between 3 and 6%. Most cases are asymptomatic, and about a quarter of these patients will develop spondylolisthesis.
The prevalence of spondylosis in athletes varies, but is not greater than in the general population. However, some sports appear to have a higher prevalence, with up to 43% reported in swimmers, 30% in wrestling competitors, 27% in throwing athletes, 23% in weightlifters, 17% in gymnasts.
The pain is usually confined to the lower back.. If it radiates, it would be to the buttocks or the posterior part of the thighs, and it is likely caused more by ligament injury than by radiculopathy. Typically, the pain increases with movements of extension of the lumbar column.
Upon inspection, an increase in lumbar lordosis can be found, and when it is associated with spondylolisthesis, the buttocks appear hardened and the spinous processes are palpated.. En algunos casos, esta palpación puede ser dolorosa.
Upon mobilization of the pelvic extremities, muscle contractures can be found, and the neurological exam is usually normal.
The vast majority of athletes with low back pain and associated spondylosis respond well to conservative treatment, which includes a brief period of relative rest, followed by physical rehabilitation. Whether or not to use some type of external immobilization, as well as the type of this immobilization, is highly controversial
Most authors agree that athletes can return to their sport even if there is no evidence of radiographic consolidation of interarticular pars.
The surgical option to treat spondylosis should be considered when conservative treatment has failed.