Spinal Problems Bone Spondylolysis

What is spondylolysis? Spondylolysis is a weakness in the connection (called the “pars interarticularis”) between the vertebrae that can lead to small stress fractures of the vertebrae. The Cleveland Clinic estimates that 3 to 7 percent of Americans have spondylolysis. It is the most common cause of lower back pain in people younger than age 26.

Causes of Spondylolysis

The exact cause of pars interarticularis weakness is unknown, although two main theories exist:

  • Repetitive trauma to the lower back can weaken the pars interarticularis. Children who participate in sports such as gymnastics, weight lifting and football are at particular risk for spondylolysis.
  • Some people are born with thin vertebrae, which places them at higher risk for fractures.

The lower lumbar spine absorbs and transmits most of the body weight and physical stresses. About 95 percent of spondylolysis cases occur at lumbar vertebra L5, and teenage athletes are particularly vulnerable to lumbar spondylolysis.

Symptoms of Spondylolysis

Spondylolysis may have no symptoms, and many people don’t know they have the condition. The most common symptom is back pain that spreads across the lower back. The pain might feel like a muscle strain and generally worsens with vigorous exercise or activity.

Treatment for Spondylolysis

Initial treatment for spondylolysis is usually rest and anti-inflammatory medications. In severe cases, a brace or back support can help stabilize the lower back as the fracture heals.

If stronger pain relief is needed, epidural steroid injections may be an option. This relief is temporary, however, and the injections have potential side effects that you’ll need to discuss with your doctor.

Physical therapy can help with a gradual return to activities. Stretching and strengthening exercises for the back and abdominal muscles can help prevent pain.

Without early treatment, spondylolysis can weaken the vertebrae so much that one vertebra slips out of place, creating another condition called spondylolisthesis. If this slippage worsens or back pain does not respond to other treatment, surgery may be an option. Surgery usually involves a spinal fusion between L5 and the sacrum.

Prevention of Spondylolysis

Spondylolysis may not be preventable, but you can reduce the risk of fractures by choosing activities and sports that don’t increase your risk of injury for your lower back. You’ll also want to keep your back and abdominal muscles strong and flexible to help support the lower back and prevent stress fractures.

Also, be aware of this difference in definition: Spondylolysis is different from the similarly spelled spondylosis, which is another word for spinal osteoarthritis.

Resources

American Academy of Orthopaedic Surgeons (AAOS) Staff. (2007). Spondylolysis and spondylolisthesis. Retrieved March 27, 2010, from http://orthoinfo.aaos.org/topic.cfm?topic=a00053

Cleveland Clinic Staff. (n.d.). Spondylolysis. Retrieved March 27, 2010, from http://my.clevelandclinic.org/disorders/Back_Pain/hic_Spondylolysis.aspx

Weinberg, E. (2008). Spondylolysis. Retrieved March 27, 2010, from http://emedicine.medscape.com/article/395916-overview