Andrew Dossett, MD, of the W.B. Carrell Clinic in Dallas, gave a presentation on lumbar fractures in sports at the 2013 North American Spine Society Annual Meeting.
He has 14 years of NFL experience covering games on the sidelines and has also worked with football, hockey, baseball and rodeo athletes.
"These fractures happen in contact sports and non-contact sports," says Dr. Dossett. In addition to treating professional athletes, Dr. Dossett sees youth athletes with spinal injuries. "I typically see [spondylolysis] in kids that are overtraining."
He addressed spondylolysis, transverse process and vertebral body fractures.
• For supportive care in a transverse process fix, he first rules out other injuries and then administers analgesics, begins modalities in the training room and works with them on advanced activity as tolerated.
• For vertebral fractures, he places athletes on bed rest until pain in manageable, for L3 and above he braces the athletes and they spend three months in the brace, then they follow core stability.
• For spondylolysis, he uses a variety of tests to identify a diagnosis and then immobilizes patients with acute fractures for thee months, braces patients with L3 fractures and above, and then at three months they start a core program.
"If teenagers and young adults can't heal it in three months, they are not going to heal it," he said. "At that point, as my Dad used to say, it's a done deal."
For patients who aren't healed by three months, he treats the patients symptomatically.
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