Management of lumbar spondylolysis in athletes: Role of imaging

© 2018, Springer Science+Business Media, LLC, part of Springer Nature. Purpose of review: Spondylolysis is a broad term, with advances in imaging enabling more accurate diagnosis of the activity and severity of a lesion. This review discusses the role of different imaging modalities in the diagnosis and management of lumbar spondylolysis in athletes. Recent Findings: Magnetic resonance imaging (MRI) has diagnostic and practical advantages over other imaging modalities and is particularly useful for detecting early stages of bone stress, including pre-symptomatic screening for active lumbar bone stress injuries. Whilst computed tomography remains the best imaging technique to visualise cortical breaches, specialised MRI sequences offer a viable alternative to detect active bone stress and chronic non-united defects. Summary: Imaging provides important information for the clinical management of athletes with lumbar spondylolysis. Roles for imaging, in particular MRI, include: (a) proactive screening and early detection, (b) diagnosis of a symptomatic lesion and (c) monitor healing and readiness to return to sport.