Spondylolysis

Spondylolysis is a common cause of lower back pain among young people. It occurs most often among children and teenagers who are active in sports that cause stress to the lower back, such as weightlifting, gymnastics, football, ballet, and volleyball. However, it can happen at any age.

When you or your child have lower back pain, you can find expert diagnosis and treatment from Advocate Brain & Spine Institute locations near you in Chicagoland.

What are the symptoms of spondylolysis?

A person with spondylolysis may not have symptoms and may only discover the condition when they have imaging of their back for another reason.

When symptoms of spondylolysis occur, they usually start with lower back pain that feels like a muscle strain. Other symptoms may include back stiffness or pain that spreads from the back to the thighs or butt muscles (buttocks).

Spondylolysis symptoms usually get worse with activity and get better with rest.

Sometimes spondylolysis symptoms involve the nerves, including:

• Pins and needles feelings in the legs
• Numbness or weakness in the legs
• Pain in the back, neck, legs, thighs or shoulders
• Muscle spasms or weakness
• Tingling or numbness in the back

If spondylolysis causes a vertebra to press on a nerve root, you may have sciatica – pain that starts in the back and travels down the back of the legs.

What are risk factors for spondylolysis?

Spondylolysis may happen during a growth spurt when bones are growing and changing quickly.

Other things that may contribute to a pars fracture are repeated back injuries or having a job that requires repetitive motions of the back such as painting or a job that requires a lot of lifting.

Spondylolysis can happen to people of all ages, and it can also happen without an injury or activity. Some people are more prone to a pars fracture because they have thinner bones in their spines, including Alaska Natives.

Diagnosis of spondylolysis

When you or your child see your doctor for potential spondylolysis symptoms, they’ll perform a physical exam and check your back and spine for:

• Areas of tenderness
• Limited range of motion
• Muscle spasms
• Muscle weakness

They’ll observe your posture and gait (the way you move when you walk). Depending on your situation, they’ll order imaging tests such as CT scan, MRI or X-rays. The results of imaging will help determine whether you have spondylolysis or another condition such as a pinched nerve, herniated disc or another type of spinal fracture.

Treatment for spondylolysis

Spondylolysis treatment should reduce your pain, allow any fractures to heal and allow the eventual return to sports or other activities. Most people recover from spondylolysis using a combination of nonsurgical techniques. In more severe cases, surgery may be recommended.

Nonsurgical spondylolysis treatment

Some nonsurgical spondylolysis treatments your doctor may recommend include:

• Rest and refraining from regular sports activities
• Back bracing
• Physical therapy to stretch and strengthen back and abdominal muscles
• Over-the-counter or prescription pain medications
• Corticosteroid medications to reduce inflammation

While you’re receiving nonsurgical treatment, X-rays will be taken at intervals to make sure your back is healing. X-rays also help judge whether the injury has caused one vertebra to slip forward over another (spondylolisthesis). If disc slippage has occurred, you may need different treatments.

Surgical treatment for spondylolysis

Surgical treatment for spondylolysis is recommended for cases that haven’t healed using nonsurgical treatment. Spine surgery is used to stabilize the spine and relieve severe back pain.

When your doctor recommends spondylolysis surgery it will likely be a fusion surgery, where two vertebrae are fused together using bone grafts and sometimes metal screws and rods. This makes two bones work together as one. Your flexibility may be decreased slightly after surgery.

After successful treatment, you or your child should have regular follow-up visits with your doctor for imaging and general monitoring of your condition.

Your doctor or physical therapist may recommend that you continue doing exercises that strengthen and stretch the back and abdominal muscles to help prevent repeat injuries or complications such as deep vein thrombosis.

What’s the recovery time for spondylolysis surgery?

When spondylolysis surgery is needed, the recovery time can be up to several months. You’ll probably be encouraged to be up and walking shortly after surgery, but you’ll need to take it easy for the early recovery period.

Your doctor will monitor your progress and let you know when it’s OK to resume activities. People who’ve had spondylolysis surgery shouldn’t return to active sports until they get permission from their doctor or surgeon.

Most people recover fully from spondylolysis after nonsurgical or surgical treatment.