{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:47:03Z","timestamp":1787755623033,"version":"build-2784847793"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>An 8-year-old girl world-level rhythmic gymnast was diagnosed with bilateral L5 pars interarticularis defects and was asymptomatic. Imaging showed bilateral spondylolysis without spondylolisthesis or degeneration. Despite recommendations for sport restriction and external scrutiny, she continued elite training under specialist surveillance. Serial imaging over 18 years demonstrated persistent defects without progression. She competed internationally for &gt;10 years without pain or limitation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Bilateral pediatric spondylolysis may remain clinically and radiographically stable despite extreme loading. This case highlights the importance of symptom-guided management and the psychosocial consequences of restrictive recommendations when radiographic findings do not correlate with clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.26.00120","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T18:00:41Z","timestamp":1779472841000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Asymptomatic L5 Spondylolysis Does Not Necessarily Preclude Elite Gymnastics Participation"],"prefix":"10.2106","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-4680-8251","authenticated-orcid":false,"given":"Brigita","family":"Budginas","sequence":"first","affiliation":[{"name":"Department of Biomedical Education, Noorda College of Osteopathic Medicine, Provo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7886-3206","authenticated-orcid":false,"given":"Prudhvi","family":"Kodali","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Cedars-Sinai Medical Center, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6137-5576","authenticated-orcid":false,"given":"David L.","family":"Skaggs","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Cedars-Sinai Medical Center, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,4]]},"reference":[{"issue":"3","key":"bib1-20260522","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1016\/j.csm.2021.03.004","article-title":"Lumbosacral spondylolysis and spondylolisthesis","volume":"40","author":"Chung","year":"2021","journal-title":"Clin Sports Med."},{"issue":"7","key":"bib2-20260522","doi-asserted-by":"crossref","first-page":"417","DOI":"10.5435\/00124635-200607000-00004","article-title":"Spondylolysis and spondylolisthesis in children and adolescents: I. Diagnosis, natural history, and nonsurgical management","volume":"14","author":"Cavalier","year":"2006","journal-title":"J Am Acad Orthop Surg."},{"issue":"10","key":"bib4-20260522","doi-asserted-by":"crossref","first-page":"1628","DOI":"10.1016\/j.spinee.2022.04.011","article-title":"Management of lumbar spondylolysis in the adolescent athlete: a review of over 200 cases","volume":"22","author":"Choi","year":"2022","journal-title":"Spine J."},{"issue":"1","key":"bib5-20260522","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1097\/JSM.0000000000000060","article-title":"Overuse injuries and burnout in youth sports: a position statement from the American Medical Society for Sports Medicine","volume":"24","author":"DiFiori","year":"2014","journal-title":"Clin J Sport Med."},{"key":"bib6-20260522","doi-asserted-by":"crossref","first-page":"80","DOI":"10.2340\/17453674.2024.42450","article-title":"An acta orthopaedica educational article: treatment of pediatric spondylolysis and spondylolisthesis","volume":"96","author":"Helenius","year":"2025","journal-title":"Acta Orthop."},{"key":"bib7-20260522","doi-asserted-by":"crossref","first-page":"796097","DOI":"10.3389\/fphys.2022.796097","article-title":"The role of neuromuscular control of postural and core stability in functional movement and athlete performance","volume":"13","author":"Zemkov\u00e1","year":"2022","journal-title":"Front Physiol."},{"issue":"13","key":"bib8-20260522","doi-asserted-by":"crossref","first-page":"459","DOI":"10.5435\/JAAOS-D-18-00147","article-title":"Artistic gymnastics injuries; epidemiology, evaluation, and treatment","volume":"27","author":"Desai","year":"2019","journal-title":"J Am Acad Orthop Surg."},{"issue":"3","key":"bib9-20260522","doi-asserted-by":"crossref","first-page":"189","DOI":"10.2165\/00007256-200636030-00001","article-title":"The role of core stability in athletic function","volume":"36","author":"Kibler","year":"2006","journal-title":"Sports Med."},{"issue":"11","key":"bib10-20260522","doi-asserted-by":"crossref","first-page":"893","DOI":"10.2165\/00007256-200838110-00002","article-title":"The importance of sensory-motor control in providing core stability: implications for measurement and training","volume":"38","author":"Borghuis","year":"2008","journal-title":"Sports Med."},{"issue":"15","key":"bib11-20260522","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1097\/BRS.0000000000004849","article-title":"Rate and duration of bone union for conservative treatment in pediatric lumbar spondylolysis","volume":"49","author":"Kuroshima","year":"2024","journal-title":"Spine (Phila Pa 1976)."},{"key":"bib12-20260522","doi-asserted-by":"crossref","first-page":"105994","DOI":"10.1016\/j.chiabu.2022.105994","article-title":"Child protective services contact and youth outcomes","volume":"136","author":"Evangelist","year":"2023","journal-title":"Child Abuse Negl."},{"key":"bib13-20260522","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.chiabu.2018.06.005","article-title":"The effect of substantiated and unsubstantiated investigations of child maltreatment and subsequent adolescent health","volume":"87","author":"Kugler","year":"2019","journal-title":"Child Abuse Negl."},{"issue":"1","key":"bib14-20260522","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1007\/s00787-021-01841-3","article-title":"Self-reported mental health of children known to child protection services: an Australian population-based record linkage study","volume":"32","author":"O'Hare","year":"2023","journal-title":"Eur Child Adolesc Psychiatry."}],"container-title":["JBJS Case Connector"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.26.00120","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:46:10Z","timestamp":1787751970000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.26.00120"}},"subtitle":["A Case Report"],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":13,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.cc.26.00120","relation":{},"ISSN":["2160-3251"],"issn-type":[{"value":"2160-3251","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]}}}