Spondylolysis

Spondylolysis is a stress fracture in one of the vertebral bones in the spine. These fractures usually occur in the lower back. Left untreated, Spondylolysis can lead to spondylolisthesis. This is a more serious condition in which one vertebra slips forward on the one below it. Both conditions can cause back pain by disturbing biomechanics in the back or by pinching the nerves in the spinal column.

Causes

Spondylolysis can be caused by:
  • Birth defect in the spine, which usually appears a few years after birth
  • Trauma to the back
  • Overextending and twisting of back muscles
  • Degenerative diseases
  • Cerebral palsy

Risk Factors

A risk factor is something that increases your chance of getting a disease condition or injury.
  • Playing sports such as:
    • Gymnastics
    • Football, especially the offensive line
    • Diving
    • Wrestling
    • Weightlifting
  • Improper athletic or exercise technique
  • Not using proper equipment for exercise or athletic activities

Symptoms

Symptoms may include:
  • Pain across the lower back
  • Spasms in the back and hamstring muscles
  • Back pain that starts during an adolescent growth spurt
Many people with Spondylolysis have no symptoms at all.

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. Tests may include: X-ray – a test that uses radiation to take a picture of the spine to look for fractures CT Scan – a type of x-ray that uses a computer to make pictures of structures inside the back MRI Scan – a test that uses magnetic waves to make pictures of structures inside the back

Treatment

If you have no symptoms from the Spondylolysis, no treatment is needed.
Treatment includes:
Exercise Restriction – Do not do athletic activities for several weeks to several months. In general, this restriction will last until the symptoms are gone.
Back Brace – Your doctor may suggest that you wear a back brace to help relieve pain.
Physical Therapy – Once the pain is gone, a physical therapist can teach you:
  • Exercises to strengthen the back and abdominal muscles that stabilize the spine
  • Proper exercise and sports techniques to help prevent overuse and further injury
Medication – The doctor may give you anti-inflammatory medications for pain relief.
Surgery – If medication, rest, and physical therapy don't heal the fracture, surgery may be considered. Two procedures are usually needed:
  • • Decompressive laminectomy – removal of excess bone and tissue that is putting pressure on the spinal cord
  • • Spinal fusion – fusing together of two vertebrae to prevent further slippage of the vertebra and stabilize that area of the spine

Prevention

To reduce your risk of getting Spondylolysis:
  • Limit participation in sports to a reasonable amount. This will help prevent overuse injury.
  • Use proper equipment for your sport.
  • Warm up properly before exercising or playing sports.
  • Learn proper techniques for exercise and athletic activities.
  • Seek medical care for chronic back pain. Early vertebral stress fractures may heal with rest.