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Vol. 41. Issue 150.
Pages 66-69 (April 2006)
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Vol. 41. Issue 150.
Pages 66-69 (April 2006)
Actitud ante un paciente deportista con espondilólisis: caso clínico
Approach to an adolescent athlete with spondylolysis: A case report
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Federico A Yáñez Silleraa, Ricard Prunab
a Máster de Traumatología del Deporte. Universidad Autónoma de Barcelona. Universidad de Barcelona. Barcelona.
b Servicios Médicos F.C. Barcelona. Barcelona.
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La espondilólisis lumbar es una causa común de dolor lumbar bajo en pacientes adolescentes deportistas. Existen distintas entidades clínicas en función de los resultados de los exámenes complementarios que condicionan distintas opciones terapéuticas. Presentamos un caso de un jugador de fútbol de 13 años que consulta por dolor lumbar bajo. El estudio radiográfico inicial presenta una espondilólisis L5 unilateral derecha. El estudio isotópico demuestra fenómenos de remodelación ósea a nivel de ambas "pars" de L5. Por tanto, se concluye el diagnóstico de espondilólisis activa L5 derecha y espondilólisis izquierda en formación. Se plantea tratamiento conservador y el control evolutivo permite observar la historia natural de dos procesos de espondilólisis distintos. El hecho de orientar la lesión como de larga evolución ha permitido tratar al paciente con los plazos de reposo pertinentes. No ha sido necesaria la colocación de un corsé delordosante debido al diagnóstico temprano realizado y al rápido cese de la sintomatología.
Palabras clave:
Espondiliosis
Lumbalgia
Lumbar spondylolysis is a common cause of low back pain in adolescent athletes. The results of complementary examinations can be used to distinguish among several clinical entities, whose therapeutic management will differ. We present the case of a 13-year-old football player who consulted for low back pain. Initial radiographic study showed unilateral right L5 spondylolysis. Isotopic study showed bone remodeling in both L5 pars. Therefore, a diagnosis of active right L5 spondylolysis and incipient left spondylolysis was made. Conservative treatment was provided and follow-up allowed the natural history of the two distinct processes to be observed. Viewing the lesion as a long-term process, allowed us to treat the patient with appropriate periods of rest. Due to the early diagnosis and the rapid disappearance of symptoms, the use of a brace to correct lordosis was not required.
Keywords:
Spondylolysis
Low back pain

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