Role of Interventional Radiology in Managing High-Level Athletes: Beyond Conventional Infiltration Techniques

Abstract

Purpose

To highlight the expanding role of interventional radiology in managing high-level athletes by presenting advanced minimally invasive procedures that extend beyond traditional infiltration techniques, aiming to accelerate recovery and preserve athletic performance.

Methods

This review explores three main interventional procedures currently implemented in elite sports medicine: (1) percutaneous computed tomography–guided screw fixation for isthmic spondylolysis, (2) vertebroplasty for posttraumatic vertebral fractures, and (3) percutaneous lumbar diskectomy under computed tomography and fluoroscopic guidance. Each technique is detailed from patient selection and procedural setup to postoperative outcomes, with emphasis on imaging guidance, anatomical precision, and rapid rehabilitation.

Results

In high-level athletes, computed tomography–guided percutaneous screw fixation for isthmic spondylolysis provides immediate biomechanical stabilization, pain relief, and early return to sport, with the option of hardware removal. Vertebroplasty in selected A1-type fractures enables full weight-bearing within 48 hours and eliminates the need for bracing. Percutaneous lumbar diskectomy offers precise decompression with minimal disruption, yielding symptom resolution within days and preserving spinal integrity. Across all procedures, interventional radiology techniques have shown low complication rates, excellent tolerance under local anesthesia, and consistent return to preinjury performance levels.

Conclusion

Interventional radiology now plays a central role in elite sports medicine, offering targeted, image-guided, and minimally invasive alternatives to traditional surgery. These techniques align with the demands of high-performance athletes, ensuring fast recovery, sustained functionality, and long-term musculoskeletal health. As interventional radiology continues to evolve, will become an essential pillar in the multidisciplinary care of professional athletes.

Keywords

computed tomography–guided procedures - percutaneous screw fixation - isthmic lysis - vertebroplasty - herniectomy

Publication History

Received: 21 September 2025

Accepted: 30 October 2025

Article published online:
20 February 2026

• References

• 1 Saraste H. Long-term clinical and radiological follow-up of spondylolysis and spondylolisthesis. J Pediatr Orthop 1987; 7 (06) 631-638
• 2 Fredrickson BE, Baker D, McHolick WJ, Yuan HA, Lubicky JP. The natural history of spondylolysis and spondylolisthesis. J Bone Joint Surg Am 1984; 66 (05) 699-707
• 3 Meyerding HW. Spondylolisthesis. Surg Gynecol Obstet 1932; 54: 371-377
• 4 Bell DF, Ehrlich MG, Zaleske DJ. Brace treatment for symptomatic spondylolisthesis. Clin Orthop Relat Res 1988; (236) 192-198
• 5 Pizzutillo PD, Hummer III CD. Nonoperative treatment for painful adolescent spondylolysis or spondylolisthesis. J Pediatr Orthop 1989; 9 (05) 538-540
• 6 Agabegi SS, Fischgrund JS. Contemporary management of isthmic spondylolisthesis: pediatric and adult. Spine J 2010; 10 (06) 530-543
• 7 Kwon BK, Albert TJ. Adult low-grade acquired spondylolytic spondylolisthesis: evaluation and management. Spine 2005; 30 (6, Suppl): S35-S41
• 8 Beutler WJ, Fredrickson BE, Murtland A, Sweeney CA, Grant WD, Baker D. The natural history of spondylolysis and spondylolisthesis: 45-year follow-up evaluation. Spine 2003; 28 (10) 1027-1035 ; discussion 1035
• 9 Osterman K, Schlenzka D, Poussa M, Seitsalo S, Virta L. Isthmic spondylolisthesis in symptomatic and asymptomatic subjects, epidemiology, and natural history with special reference to disk abnormality and mode of treatment. Clin Orthop Relat Res 1993; (297) 65-70
• 10 Möller H, Hedlund R. Surgery versus conservative management in adult isthmic spondylolisthesis—a prospective randomized study: part 1. Spine 2000; 25 (13) 1711-1715
• 11 Amoretti N, Huwart L, Hauger O. et al. Computed tomography- and fluoroscopy-guided percutaneous screw fixation of low-grade isthmic spondylolisthesis in adults: a new technique. Eur Radiol 2012; 22 (12) 2841-2847
• 12 Amoretti N, Cervantes E, Stacoffe N, Foti P, Litrico S, Kastler A. Trans-isthmic pars interarticularis screw fixation under CT and fluoroscopic guidance: technical success and clinical outcome in patients with symptomatic low-grade lumbar isthmic lysis. Eur Radiol 2021; 31 (11) 8264-8271
• 13 Galibert P, Deramond H, Rosat P, Le Gars D. Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty. [in French]. Neurochirurgie 1987; 33 (02) 166-168
• 14 Huwart L, Foti P, Andreani O. et al. Vertebral split fractures: technical feasibility of percutaneous vertebroplasty. Eur J Radiol 2014; 83 (01) 173-178
• 15 Anselmetti GC, Bernard J, Blattert T. et al. Criteria for the appropriate treatment of osteoporotic vertebral compression fractures. Pain Physician 2013; 16 (05) E519-E530
• 16 Cotten A, Boutry N, Cortet B. et al. Percutaneous vertebroplasty: state of the art. Radiographics 1998; 18 (02) 311-320 ; discussion 320–323
• 17 Laredo JD, Chiras J, Kemel S, Taihi L, Hamze B. Vertebroplasty and interventional radiology procedures for bone metastases. Joint Bone Spine 2017
• 18 Bonnard E, Foti P, Kastler A, Amoretti N. Percutaneous vertebroplasty under local anaesthesia: feasibility regarding patients' experience. Eur Radiol 2017; 27 (04) 1512-1516
• 19 Cypress BK. Characteristics of physician visits for back symptoms: a national perspective. Am J Public Health 1983; 73 (04) 389-395
• 20 Luo X, Pietrobon R, Sun SX, Liu GG, Hey L. Estimates and patterns of direct health care expenditures among individuals with back pain in the United States. Spine 2004; 29 (01) 79-86
• 21 Amoretti N, Hauger O, Marcy PY. et al. Percutaneous discectomy on lumbar radiculopathy related to disk herniation: why under CT guidance? An open study of 100 consecutive patients. Eur J Radiol 2012; 81 (06) 1259-1264
• 22 Ranc PA, Dien E, Pavan LJ. et al. Patient experience following CT-guided percutaneous lumbar discectomy under local anesthesia: a prospective study. Eur Radiol 2025
• 23 Ranc PA, Rudel A, Bentellis I. et al. Patient-reported outcomes and return to work after CT-guided percutaneous lumbar discectomy: a prospective study. J Vasc Interv Radiol 2024; 35 (03) 390-397