Spondylolysis

Spondylolysis

Spondylolysis is a stress fracture of vertebra that may progress into spondylolisthesis, a condition of displacement of vertebrae from the spinal column. Spondylolysis is a cause for frequent low back pain in children. It is more common among children and teenagers who participate actively in sports such as football, weightlifting and gymnastics.

Causes

Spondylolysis occurs because of a defect or stress fracture in the pars interarticularis, the part of the lumbar spine joining the upper and lower joints. Genetic factors may have a role and some Children are prone to vertebral stress fractures or may have lesions as a developmental phenomenon. Also, repetitive trauma to the lower back area that occurs during sports and other activities can cause weakness of the pars interarticularis, resulting in spondylolysis.

Symptoms

Although initially the patient may not have any symptoms, lower back pain is apparent during the teenage growth spurt period. The pain worsens with vigorous physical activities and exercises. At times, the pain may feel like a muscle strain.

Risk Factors

Risk factors for developing spondylolysis include:

  • Family history of back problems
  • Repetitive trauma tothe lower back 
  • Increased lordosis (swayback)
  • Incomplete development of spinal cord (spina bifida occulta) and
  • Participation in sports such as football, gymnastics and weightlifting that require constant overstretching of spine

Complications

Untreated spondylolysis may lead to further complications including:

  • Spondylolisthesis, a condition where one or more vertebrae slip out of place
  • Limited mobility and inactivity
  • Weight gain because of inactivity
  • Loss of bone density
  • Loss of muscle strength
  • Loss of flexibility
  • Permanent nerve damage
  • Chronic back pain
  • Numbness, tingling or weakness in the legs

Diagnosis

Your surgeon diagnoses spondylolysis by asking several questions and performing several tests that include:

  • Family History
  • Medical History
  • Physical Examination
  • X-ray
  • CT scan or MRI scan

Treatment

Primary treatment for spondylolysis is always conservative. The goal of the conservative treatment is to reduce the pain, allow the fracture to heal and improve the function

Conservative treatment options include:

  • Rest: Adequate rest should be taken and strenuous exercises should be avoided until the symptoms subside
  • Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) may be prescribed to reduce the pain and inflammation. If NSAIDs do not provide relief, epidural steroid injections may be administered to the spine to reduce pain, numbness and tingling in the legs
  • Physical therapy: An exercise program helps to strengthen the abdominal and back muscles, improve flexibility and increase range of motion of the lower back
  • Use of braces: In severe cases of spondylolysis, a brace or back support may be used to stabilize the lower back during fracture healing

Prevention

Although spondylolysis is not completely preventable, certain factors can reduce the risk of developing the condition:

  • Maintaining a healthy weight to reduce stress on the lower back
  • Core exercises to keep the abdominal and back muscles strong will help to support the lower back
  • Eating a well-balanced diet to keep your bones strong

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