Low back pain characteristics in adolescent patients with early-stage spondylolysis: a prospective study

Early-stage spondylolysis (ESS) is a common cause of acute low back pain (LBP) in adolescents. When treating patients with ESS, early diagnosis is essential, yet difficult without magnetic resonance imaging. This study evaluates a self-reported questionnaire for detecting ESS.

We evaluated a total of 69 adolescents (≤ 18 years old) with acute LBP (≤ 1 month) with plain radiography, magnetic resonance imaging and a questionnaire including the following parameters: exercise frequency per week, daily training time, the necessity for stopping sports activity, pain-producing situations, pain quality, pain response to hyperextension or hyperflexion, pain location, and pain extent. Patients with obvious pathological findings other than ESS (e.g., disk herniation or infection) were excluded. The correlation of each question and gender, regarding ESS was determined, to evaluate the value of the originally developed questionnaire.

24 out of 69 patients were diagnosed with ESS (ESS group), with a mean age of 13.9 years old and 21 males and 3 females in the group. 45 patients had NS-LBP, with a mean age of 14.6 years old, and 28 males and 17 females in the group. Correlation analyses showed weak associations between ESS and higher frequency of exercise per week, longer training time per day, and pain-producing situations. There was also a moderate association between ESS and male gender.

Exercise frequency, training time, pain-provoking situations, and gender could be important factors to detect ESS within this questionnaire.