Spondylolysis happens when a crack forms in the bony ring on the back of the spinal column. It occurs most commonly in the lower back. The bony ring protects the spinal cord fractures as a result of excessive or repeated strain. The affected area is called the pars interarticularis, so doctors sometimes refer to this condition as a pars defect.
The condition affects approximately six percent of children. It primarily affects young athletes that participate in sports in which the spine is repeatedly bent backwards, such as gymnastics, karate, martial arts and football.
Spondylolysis is typically caused by a stress fracture of the bone. As mentioned above, it often affects young athletes that participate in sports that put repeated strain on their lower spine. It also runs in families and can be more prevalent in certain populations.
Symptoms of Spondylolysis include pain and stiffness in the center of the lower back. Bending backwards may increase the pain. Some people experience pain that radiates down one or both legs.
Diagnosis begins with a complete history and physical examination by your physician. Most likely, an x-ray of your lower back will be taken. In some cases, a bone scan will be ordered if the x-ray is inconclusive. A CT scan may also be ordered. This is a very detailed x-ray that allows the doctor to see slices of the body’s tissue. This scan can show whether the fracture is recent or not. Lastly, if more information is needed, an MRI (magnetic resonance imaging) scan could be ordered. This test uses magnetic waves rather than X-rays to show the soft tissues of the body.
Treatment often begins with monitoring the condition and taking x-rays every few months to check the healing process. Your doctor may ask you to limit the amount of physical activity you do and may refer you to see a physical therapist who can help you design an exercise program to improve strength and control of your back.
Most patients with spondylolysis do not require surgery. However, if symptoms are not relieved by limiting physical activity and with physical therapy, surgery may be required. There are two surgical procedures used to treat spondylolysis. They are:
- posterior lumbar fusion
To learn about these and other surgical procedures, click here.
Am I at risk for spondylolysis?
Typically, persons who participate in physical activities such as football, weight lifting, martial arts, gymnastics, etc. are at greater risk. However, those with a family history of spondylolysis are also susceptible to developing the condition.