We studied prospectively 22 young athletes who had undergone surgical treatment for lumbar spondylolysis. There were 15 men and seven women with a mean age of 20.2 years (15 to 34). Of these, 13 were professional footballers, four professional cricketers, three hockey players, one a tennis player and one a golfer. Preoperative assessment included plain radiography, single positron-emission CT, planar bone scanning and reverse-gantry CT. In all patients the Oswestry disability index (ODI) and in 19 the Short-Form 36 (SF-36) scores were determined preoperatively, and both were measured again after two years in all patients. Three patients had a Scott’s fusion and 19 a Buck’s fusion.

The mean duration of back pain before surgery was 9.4 months (6 to 36). The mean size of the defect as determined by CT was 3.5 mm (1 to 8) and the mean preoperative and postoperative ODIs were 39.5 (sd 8.7) and 10.7 (sd 12.9), respectively. The mean scores for the physical component of the SF-36 improved from 27.1 (sd 5.1) to 47.8 (sd 7.7). The mean scores for the mental health component of the SF-36 improved from 39.0 (sd 3.9) to 55.4 (sd 6.3) with p < 0.001. After rehabilitation for a mean of seven months (4 to 10) 18 patients (82%) returned to their previous sporting activity.

The incidence of symptomatic pars defect varies between 15% and 47% in the young athletic population. We have analysed the outcome of direct repair spondylolysis on young professional athletes.

We have prospectively studied 22 young athletes with lumbar spondylolysis in whom conservative treatment has failed. Fifteen male and 7 female patients with a mean age of 20.2 years (range 15–34 years) were surgically treated for radiographically confirmed spondylolysis between 1994 and 1999. Eleven patients were professional footballers and four were professional cricketers. Pre-operative assessment included plain X rays, SPECT imaging with planar bone scan and reverse gantry CT scans. All patients had the Oswestry disability index (ODI) and 19 patients had Short Form 36 (SF-36) scores recorded pre-operatively and two years post operatively. Nineteen patients underwent Buck’s fusion and 3 underwent Scott’s fusion. At two-year follow-up nineteen patients had ODI and SF36 scores recorded. Return to the sporting activity at the previous level was regarded as a successful outcome.

The average duration of back pain prior to surgery was 8.9 months (range 1-36 months). The mean lysis defect determined by CT was 3.5 mm (range 1–8 mm). The mean pre-operative ODI was 39.5 (SD=8.7) and the mean post-operative ODI was 10.7 (SD=12.9). The mean scores of the physical health component of SF-36 improved from 27.1 (SD=5.1) to 47.8 (SD=7.7). The mean scores of the mental health component of SF-36 improved from 39.0 (SD=3.9) to 55.4 (SD=6.3) [P < 0.001].

The surgical repair of bilateral spondylolysis with modified Buck’s fusion in professional sportsmen and women results in a significant improvement in Oswestry Disability scores (p< 0.001) and in all domains of SF36 health questionnaire (p< 0.001). Ninety five percent of patients in this group return to active sport within seven months of surgery.