Spondylolysis

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Spondylolysis is a common cause of lower back pain specifically in young athletes occurring when a stress fracture causes vertebra to slip or shift out of place, specifically during periods of rapid growth.  If left untreated, weakening of the vertebra can continue until the spine is unable to maintain proper position.

This is most likely to occur in sports requiring frequent overstretching, such as gymnastics, football, and weight lifting.  In many cases, patients don’t exhibit any symptom and spondylolisthesis may not be discovered until imaging tests are taken for an unrelated condition.

When symptoms do occur, they most commonly present with lower back pain which will likely feel similar to a muscle strain, may radiate to the buttocks and thighs, and worsen with activity.  Muscle spasms may cause additional symptoms, including:

  • Back stiffness
  • Tight hamstrings
  • Difficulty standing and walking

In cases of a severe slippage, patients may have tingling, numbness, or weakness in one or both legs.

Upon examination, your doctor will take a complete medical history, specifically asking which sports are being played.  Your doctor will look for:

  • Areas of tenderness in the spine
  • Limited range of motion
  • Muscle spasms
  • Muscle weakness
  • Posture issues
  • Stiff-legged gait

Your doctor may also request imaging tests such as X-rays, CAT scans, and MRIs to look for stress fractures, view the alignment of the vertebrae, and view the soft tissues between vertebrae.

Nonsurgical treatments will likely be recommended, such as:

  • Rest
  • NSAIDs
  • Physical Therapy
  • Bracing

Surgery may be required if the patient is exhibiting a severe slippage, a slippage that is progressing or worsening, or back pain that has not improved with nonsurgical treatments.  Your surgeon will likely perform a spinal fusion to prevent further slippage, stabilize the spine, and alleviate back pain.