Spondylolysis is a crack or tiny bone fracture that occurs in a specific part of a vertebra, the small bones that make up your spine. This fracture happens in the pars interarticularis—a small, thin ridge of bone that links the vertebrae together.
This condition is a common cause of back pain, especially in young athletes. It is distinct from spondylolisthesis, which is the slippage of one vertebra onto another. However, spondylolysis is the most common cause of isthmic spondylolisthesis, as the fracture in the pars interarticularis can weaken the bone, allowing it to slip out of alignment.
Causes and Risk Factors
The most common cause of spondylolysis is repetitive stress or trauma, which weakens the pars interarticularis until it fractures.
- Athletics: The condition is strongly linked to sports, particularly those involving contact, jumping, or frequent over-stretching of the spine.
- Growth Spurts: It is often diagnosed in kids and teens during growth spurts, when their bones are more vulnerable to stress.
- Trauma: Less commonly, a sudden, acute injury like a fall or car accident can cause the fracture.
Symptoms of Spondylolysis
While some individuals may have spondylolysis and never experience symptoms, the fracture can cause instability and pain. Common symptoms include:
- Lower back pain, which is the most frequent complaint.
- Back stiffness.
- Pain that spreads (radiates) into the buttocks or thighs.
- Sciatica, which involves numbness, weakness, or tingling in the feet.
- Difficulty walking or standing for long periods.
Diagnosis and Management
A healthcare provider will diagnose spondylolysis using a physical exam and imaging tests. A spinal X-ray, CT scan, or MRI can be used to confirm the fracture.
The goal of treatment is to manage pain and allow the fracture to heal. Most cases respond very well to nonsurgical treatments, including:
- Rest: A break from sports and other intense physical activities is essential.
- Bracing: Your provider may recommend a back brace to stabilize the spine and promote healing.
- Physical Therapy: A physical therapist will provide exercises to strengthen the core (abdominal muscles) and back muscles, which helps relieve stress on the spine.
- Medication: Over-the-counter NSAIDs can help reduce pain and inflammation.
If nonsurgical treatments don’t relieve severe symptoms, or if the fracture leads to a high-grade slippage, your provider may suggest surgery, such as a spinal fusion, to restore stability.
