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.
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Factors that may increase the chance of spondylolysis include:
- Playing sports, such as gymnastics, football, diving, wrestling, or 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)
If you have symptoms, treatment may include:
Do not do athletic activities for several weeks to several months. In general, this restriction should last until the symptoms are gone.
Your doctor may suggest that you wear a back brace. This will help relieve pain. About 4-6 weeks of bracing may be needed. The brace should limit extension of the lower (lumbar) spine.
To relieve the pain and prevent recurrences, a physical therapist can teach you:
- Exercises to strengthen the back and abdominal muscles—these muscles stabilize the spine
- Proper exercise and sports techniques to help prevent overuse and further injury
- Hamstring stretches
The doctor may give you medications for pain relief.
Surgery may be needed if there is:
- Injury to the nerve
- High-grade spondylolisthesis (more than 50% slippage)
- No relief from medications, rest, activity modification, and physical therapy
Two procedures are usually needed:
- Decompressive laminectomy — removal of bone and tissue that are putting pressure on the spinal nerves
- Spinal fusion —fusing together of the two involved vertebrae to prevent further slippage of the vertebra
To help reduce your chance of 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.
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.
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Healthy Children—American Academy of Pediatrics http://www.healthychildren.org
Ortho Info—American Academy of Orthopaedic Surgeons http://www.orthoinfo.org
Canadian Orthopaedic Association http://www.coa-aco.org
Canadian Orthopaedic Foundation http://www.canorth.org
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