Spondylolysis

Overview

Definition

Spondylolysis is a stress fracture in one of the vertebrae (spinal bones) in the lower back. It may be on one or both sides.

Early treatment can improve outcomes.

Spondylolysis
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Causes

This problem is caused by doing repetitive tasks, such as flexing, extending, or rotating the lower back. This leads to trauma that happens over time.

Risk Factors

This problem is more common in young adults, especially those who do sports. It is also more common in men.

Other things that may raise the risk are:

  • Having other family members with this health problem
  • Playing sports, such as gymnastics, soccer, and basketball

SymptomsandDiagnosis

Symptoms

Most people do not have symptoms. Others may have:

  • Low back pain
  • Pain that is worse with activity and better with rest
  • Muscle pain
  • Pain that spreads to the buttocks and the back of the thighs

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done. It will focus on the back.

Images of the spine may be taken. This can be done with:

  • X-rays
  • MRI scan
  • CT scan
  • PET/CT scan

Treatments

Treatment

The goal of treatment is to manage symptoms and promote healing. Medicines will be given to ease pain. Other choices are:

  • Avoiding physical activities that put stress on the back
  • Wearing a brace to limit movement
  • Physical therapy to promote strength, flexibility, and range of motion

People who are not helped by these methods may need surgery. Choices are:

  • Spinal fusion to fuse two vertebrae together
  • Using a strong screw to hold the fracture together

Prevention

There are no known guidelines to prevent this health problem.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.

RESOURCES

Healthy Children—American Academy of Pediatrics http://www.healthychildren.org 

Ortho Info—American Academy of Orthopaedic Surgeons http://www.orthoinfo.org 

CANADIAN RESOURCES

Canadian Orthopaedic Association http://www.coa-aco.org 

Canadian Orthopaedic Foundation http://www.canorth.org 

References

Goetzinger S, Courtney S, et al. Spondylolysis in young athletes: An overview emphasizing non operative management. J Sports Med (Hindawi Publ Corp). 2020;2020:9235958. Published 2020 Jan 21.

Lumbar spondylolysis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/lumbar-spondylolysis. Accessed February 17, 2021.

Nitta A, Sakai T, et al. Prevalence of Symptomatic Lumbar Spondylolysis in Pediatric Patients. Orthopedics. 2016;39(3):e434-e437.

Overley SC, McAnany SJ, Andelman S, et al. Return to play in adolescent athletes with symptomatic spondylolysis without listhesis: A Meta-analysis. Global Spine J. 2018;8(2):190-197.

Selhorst M, Allen M, et al. Rehabilitation considerations for spondylolysis in the youth athlete. Int J Sports Phys Ther. 2020;15(2):287-300.