What is spondylolysis?
Spondylolysis (spon-dee-low-lye-sis) is a small crack or fracture between two vertebrae in your spine. This most commonly affects your lower back but can also happen in the other sections of your spine, like your neck or middle back. It can occur on one side (unilateral) or both sides (bilateral) and at any level of the spine, but most often at the fourth or fifth lumbar vertebra.
If spondylolysis is present, then you have the potential to develop spondylolisthesis. Spondylolisthesis is the slipping forward of the vertebral bone causing pinched nerves and pain.
It is estimated that spondylolysis affects less than 10% of Americans each year, and is more common in kids and teens, especially those involved in sports.
What causes spondylolysis?
Damage to parts of your vertebrae, called the pars interarticularis, is the main cause of spondylolysis. These thin pieces of bone link your vertebrae directly above and below each other that lets your spine move and flex. Any damage to these bones can cause a crack, including:
- Overuse – repetitive motion or stress on your low back.
- Growth spurts
- Genetics
Again, anyone can experience spondylolysis, but certain groups of people have higher risks. Athletes who play contact sports, kids and teens who are still growing and changing, and people of Indigenous descent are more likely to be susceptible to spondylolysis.
What are the symptoms of spondylolysis?
Lower back pain is the most common symptom of spondylosis. Some people actually never experience symptoms – it is discovered during an imaging test being done for other reasons. However, with people experiencing pain, the pain usually:
- Spreads from your lower back into your thigh and buttocks.
- Feels like a muscle strain in or around your lower back.
- Gets worse with physical activity.
- Improves with rest.
How is spondylolysis diagnosed?
Your healthcare provider will work to diagnose spondylolysis by performing a physical exam and inquiring about symptoms and medical history. They may also need imaging tests to take pictures of your vertebrae and tissue around your spine.
What are treatment options for spondylolysis?
Treatment will depend on which vertebrae are affected and the severity of the cracks. It is rare for surgery to be needed with spondylolysis; however some people do require surgery to stabilize their spine. The most common treatments for spondylolysis include:
- Rest
- Medications
- Epidural Steroid Injections
- Physical therapy
- Bracing
Your provider will determine which course of treatment is right for you. These fractures can take up to six months to heal, but most people start to feel better as soon as they start treatment. It is important to follow instructions provided by your provider to allow your spine to heal completely.
As you start to have less pain and more flexibility, you will be able to gradually return to normal activities. Be sure to consult your healthcare provider before returning to heavy activities.
If you have any questions or would like to schedule an appointment with one of our Spine Center specialists, please call 515.875.9560.