Elite male adolescent gymnast who achieved union of a persistent bilateral pars defect

Allan Vrable, Andrew L. Sherman

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


An adolescent 15-yr-old male competitive gymnast presented to a university-based multidisciplinary spine institute with a persistent low-back pain for 18 mos. Although the results of x-rays were negative, his pain rendered him unable to compete in his sport any longer. A computed tomography scan was performed, which showed a bilateral pars fracture at L5, without spondylolisthesis. A nuclear medicine bone scan revealed negative findings, confirming chronic nonunion. The patient completed a 4-wk course of physical therapy 6 mos before our intervention, without any relief of pain or radiologic evidence of healing. The patient was treated with a bone stimulator for 4 hrs/day and was recommended to wear a warm-and-form-type brace. Isometric core trunk exercises were also initiated. Only after 6 wks of treatment, the subject showed clinical improvement at the follow-up visit. Computed tomography scan performed 12 wks after the initial scan showed complete union of the fracture correlating with clinical improvement. Two years later, the athlete remains completely pain-free, is training regularly, and is able to compete on a national and, possibly, international level.

Original languageEnglish (US)
Pages (from-to)156-160
Number of pages5
JournalAmerican Journal of Physical Medicine and Rehabilitation
Issue number2
StatePublished - Feb 2009


  • Back pain
  • Rehabilitation
  • Spondylolysis
  • Treatment

ASJC Scopus subject areas

  • Rehabilitation
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Medicine(all)


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