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Lumbar spondylolysis is common in pediatric athletes, and many athletes can return to sports with conservative treatment. There are two initial treatment strategies bony union or pain management, but the outcomes of these strategies have not been clarified. The purpose of this study is to investigate the rates of return to sports (RTS) and recurrence in pediatric athletes after conservative treatment for lumbar spondylolysis and to compare both treatment strategies. A total of 180 patients with lumbar spondylolysis were managed with a t