As you read this, I imagine many of you will spend the remainder of today looking at the infamous NCAA March Madness brackets, filling in the teams that you hope will win each game and hoping that you win the $1 billion prize from Warren Buffet.  Some teams have been affected by injuries and may not be as capable as you remember them from earlier in the season.  One of these teams is the Kansas Jayhawks, whose 7-foot center, Joel Embiid, recently suffered a spinal stress fracture and will miss the first week of the NCAA tournament.  Read the article here.

A spinal stress fracture is medically known as a vertebral spondylolysis and is more common in certain sports such as football, gymnastics, weight lifting and javelin throwing.  The fracture is at the pars interarticularis portion of the vertebrae.  It is the most common cause of low back pain that can be seen via X-ray imaging in adolescent athletes.  Hyperextension of the spine leads to the increased stress on the spine.  Before the actual fracture (spondylolysis), there can be a “stress reaction” in the vertebrae that may present as low back pain.  Traditional X-rays may not show any abnormality in a stress reaction, but changes can be seen on an MRI.

Proper treatment for spondylolysis is initially non-surgical and includes rest, avoidance of the hyperextension activities and anti-inflammatory medication.  Bracing and physical therapy for stretching and strengthening may be indicated.  If no response is seen to conservative management, surgery can be considered, although in the adolescent/young adult athlete population, the risks and benefits of back surgery must be strongly assessed.  The majority of athletes with spondylolysis likely return to competitive sports within one year.

So if Kansas is not your favorite team now, who should you pick?  My money is on the Manhattan Jaspers to pull off the upset of the year.  See the article here.


Stuart J. Glassman, MD

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