Spondylolysis

Spondylolysis is a stress fracture. It occurs in a part of the vertebrae (spinal bone). The pars interarticularis is a portion of the bone between the facets. There is a right and left section. This condition occurs in the lower back. About 90% of the time, it is in the fifth lumbar vertebra. It can fracture on one or both sides (bilateral). Left untreated, it can lead to spondylolisthesis. This is a more serious condition. The vertebra slips forward on the one below it. Both conditions can cause back pain. This fracture is the most common cause of back pain in adolescent athletes.

  • Causes


    Spondylolysis can be caused by:

    • Congenital defect in the spine (usually appears a few years after birth)

    • Acute
      trauma
      to the back
    • Degenerative conditions of the spine

  • Definition

    Spondylolysis is a stress fracture. It occurs in a part of the vertebrae (spinal bone). The pars interarticularis is a portion of the bone between the facets. There is a right and left section.

    This condition occurs in the lower back. About 90% of the time, it is in the fifth lumbar vertebra. It can fracture on one or both sides (bilateral). Left untreated, it can lead to spondylolisthesis. This is a more serious condition. The vertebra slips forward on the one below it. Both conditions can cause back pain.

    This fracture is the most common cause of back pain in adolescent athletes.

    Spondylolysis
    Nuclus factsheet image
    Copyright © Nucleus Medical Media, Inc.

  • Diagnosis

    The doctor will ask about your symptoms and medical history. A physical exam will be done.


    Imaging tests to find the fracture and look for other problems in the soft tissue may include:

    • X-rays
    • CT scan
    • Single photon emission computed tomography
    • MRI scan

  • Prevention


    To reduce your risk of getting spondylolysis:

    • Limit how much you participate in certain sports. This will help prevent overuse injury.
    • Keep the abdominal and back muscles strong. Keep the hamstring muscles supple.
    • 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, particularly in teens and young adults, may heal with rest.

  • Risk Factors


    Factors that increase the chance of spondylolysis:

    • Genetics
    • Playing sports (such as gymnastics, football [especially the offensive line], diving, wrestling, weightlifting)
    • Improper athletic or exercise technique
    • Adolescent growth spurt
    • Chronic overextension (bending backwards) with or without side bending of the back (common in certain sports and activities)
    • Hamstring tightness or muscle imbalance
    • Cerebral palsy
      (less common)

  • Symptoms


    Symptoms may include:

    • Pain across the lower back
    • Spasms in the back and hamstring muscles
    • Pain radiating down the leg

    Many people have no symptoms at all.

  • Treatment

    If you have symptoms, treatment may include: