Safety and efficacy of aggressive exercise therapy for patients with unilateral early-stage spondylolysis: A retrospective comparative cohort study

Introduction: Bony union in patients with early-stage spondylolysis can be achieved using a rigid corset and avoiding sports activities. However, prolonged absence from sports activities may decrease physical fitness. This study aimed to investigate the safety and efficacy of aggressive exercise therapy for patients with early-stage spondylolysis (ESS).

Methods: Thirty-one patients (aged <19 years; 26 males) diagnosed with unilateral ESS were divided into light intensity (L group; n = 16) and aggressive (A group; n = 15) exercise groups. All patients wore a hard corset and received light intensity (L group) or aggressive (A group) exercise therapy for 2-3 months. After treatment, the bony union was assessed using magnetic resonance imaging and computed tomography. The mean interval between the initial and second computed tomography examinations, including treatment drop-out rates, was determined.

Results: Second computed tomography examination results showed that bony union was either improved or achieved in both groups. The mean interval between the initial and second computed tomography examinations was 78.1 ± 19.7 and 78.1 ± 17.4 days in the L and A groups, respectively, with no significant difference. The L group had a higher drop-out rate (n = 5; 31.3%) than the A group (n = 1; 6.7%), albeit not significant.

Discussion: Both groups showed bony union after treatment, suggesting that aggressive exercise therapy was safe and effective for patients with unilateral ESS. Moreover, the lower drop-out rate in group A suggests that aggressive exercise therapy maintained the patients' adherence to long-term treatment.

Conclusions: Aggressive exercise therapy was effective-to-safe and maintained good motivation in patients with ESS.