Spondylolysis is a common cause of low back pain and occurs when there is a crack or stress fracture in one of the vertebrae in the spinal column.
The spine is made up of 24 bones, called vertebrae, which are stacked on top of one another. These bones connect to protect the spinal cord. The seven small vertebrae that begin at the base of the skull and form the neck comprise the cervical spine.
Your spinal cord and nerves travel through the spinal canal carrying messages between your brain and muscles. The intervertebral discs between your vertebrae are flexible, flat and round discs and are about a half-inch thick. They act as shock absorbers when you walk or run and allow motion between the vertebrae.
In spondylolysis, a crack or stress fracture develops through the small, thin portion of the vertebra that connects the upper and lower facet joints of the spine, which is the weakest portion of the vertebra. The fracture commonly occurs in the fifth vertebra of the lower spine. Fractures can occur on one side or both sides of the bone.
Spondylolysis can occur in people of all ages but most often occurs in children and adolescents who participate in sports that involve repeated stress on the lower back such as football, weightlifting and gymnastics.
In some cases, the stress fracture weakens the bone and causes the vertebra to shift or slip out of place. This causes spondylolisthesis.
- Lower back pain
- Pain similar to a muscle strain
- Pain that radiates to the back of the thighs and buttocks
- Pain that worsens with activity and improves with rest
To determine whether you have spondylolysis your physician will ask you for a complete medical history and conduct a physical examination. An X-ray can confirm the diagnosis, sometimes a CT scan or MRI is necessary to rule out other issues.
Treatment for spondylolysis is always nonsurgical unless spondylolisthesis has developed. Nonsurgical treatment options will reduce pain, allow fracture to heal and allow patient to return to daily activities. Nonsurgical treatment options include:
- Nonsteroidal anti-inflammatory drugs such as ibuprofen to reduce swelling and pain
- Physical therapy
- Bracing to limit movement
To help prevent future injury your physician may recommend specific exercises and stretches to strengthen the back. Additionally, regular check-ups may be necessary to ensure spondylolisthesis does not develop.