An antilordotic brace commonly utilizes a plastic component that is contoured to closely fit the body. Antilordotic bracing subsequently reduces the athlete’s symptoms by decreasing the amount of stress on the low back, and allows a prompt return to sport for athletes. Typically, bracing is utilized for 6–12 weeks.In order for a brace to be effective, it must be worn every day for the required amount of time. Patients are given a brace schedule determined by their physical therapist that explains the amount of time the brace must be worn daily. A braces effectiveness increases with adherence to the bracing schedule. Patients that do not follow their bracing schedule are more likely to have their symptoms progress. Research has demonstrated that when braces are used as prescribed with full compliance, they are successful at preventing spondylolysis progression. Surgery
Most patients with spondylolysis do not require surgery but, if the symptoms are not relieved with non-surgical treatments, or when the condition progresses to high grade spondylolisthesis, then patients may require surgery. There are two main types of surgery for this condition:
Spinal fusion: This procedure is recommended when a set of vertebrae becomes loose or unstable. The surgeon joins two or more bones (vertebrae) together through the use of metal rods, screws, and bone grafts. The bone grafts complete their fusion in 4–8 months following the surgery, securing the spine in the correct position. The procedure is also used to treat spinal instability, fractures in the lumbar spine and, severe degenerative disc disease.
The process is relatively non-invasive, performed through small incisions and has a high success rate. Laminectomy: Often performed when spinal stenosis occurs in conjunction with spondylolysis. The procedure surgically removes part or all of the lamina from the bony ring of the vertebra to reduce the pressure on the spinal cord. The laminectomy is commonly performed on the vertebrae in the lower back and in the neck. Implications for rehabilitation
Spondylolysis can have a huge impact on a young athletes career, and may impede their future ability to perform. It is important to understand how social and psychological factors may affect rehabilitation of an injured athlete. Frustration, anger, confusion, fear and depression are some of the psychological factors that injured athletes experience, therefore a debilitating injury can have a large impact on an athletes mental well-being. These psychological factors can also affect recovery and return to sport as fear of re-injury often prevents athletes from adhering to rehabilitation and returning to their sport at full intensity.Social factors can also impact the cognitive, behavioural and physical responses to injury. More specifically, social isolation from the team can have a profound psychological effect. This makes it essential to provide social support through supportive listening, emotional support, personal assistance, and reality conformation.It is also critical to educate the athletes on the rehabilitation process so they know what to expect. For instance, explaining what activities to avoid and will cause pain as well as the duration of the treatment process.