Spondylolysis

What is it and how is it treated?

What is spondylolysis?

Spondylolysis is a crack or stress fracture in one of the vertebrae, the small bones that make up the spinal column.

It develops through the pars interarticularis, which is a small, thin portion of the vertebral bone that connects the upper and lower facet joints.

In most cases, the fracture occurs in the lower spine’s fourth or fifth lumbar vertebra.

Stress fractures are most likely to be found in the pars interarticularis because it is the weakest portion of the vertebra.

The fractures are caused by repetitive stress and overuse. In addition, many young athletes develop spondylolysis because their bones are still developing.

Many times, patients with spondylolysis will also have some degree of spondylolisthesis. Spondylolysis and spondylolisthesis are related but not the same.

The slippage is called spondylolisthesis when the fracture causes the vertebral body to slip forward.

What are the symptoms of spondylolysis?

It is quite difficult to identify spondylolysis without an expert diagnosis.

When symptoms are present, they usually appear as lower back pain or muscle spasms. However, it may feel like a muscle strain with the pain radiating to the buttocks and the back of the thighs.

How is spondylolysis diagnosed?

After discussing your medical history, the orthopedic doctor will perform a physical examination of your back and spine, looking for:

  • areas of tenderness
  • limited range of motion
  • muscle spasms
  • muscle weakness

If there is a chance that you have spondylolysis, the condition will need to be confirmed through imaging tests.

The following tests may be used to confirm spondylolysis:

  • X-rays. These are used to take images from several different angles to look for stress fractures and view the vertebrae’s alignment. For example, if the pars interarticularis has a stress fracture, it may indicate spondylolysis.
  • Computerized tomography (CT) scans. These give a more detailed view than plain x-rays. As a result, CT scans can be more useful in planning treatment.
  • Magnetic Resonance Imaging (MRI). This can provide an additional view of soft tissues in and around the spine.
  • Bone scan. These may be required sometimes if the x-ray does not give a diagnosis.

What are the treatment options for spondylolysis?

At OrthoNeuro, we use a multi-disciplinary team of surgeons, physical medicine, rehabilitation physicians, and physical therapists to diagnose, treat, and rehabilitate injuries to the spine. Treatment for spondylolysis is designed to:

  • relieve pain
  • allow the fracture to heal
  • rehabilitate the patient so that they can return to daily activities and participation in sports.

Non-surgical Treatments

Initially, the team at OrthoNeuro will begin with conservative treatment options to treat spondylolysis. This is usually sufficient to treat the condition.

Non-surgical treatment may include:

Rest. A period of rest from sports or other activities will usually help to improve back pain and other symptoms.

Non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs reduce pain and swelling in the back.

Physical therapy. Exercises can be given to strengthen back and abdominal muscles and improve flexibility in the hamstring muscles.

Back brace. A brace can be used to allow the recent pars fracture to heal.

Throughout treatment, your doctor will take periodic x-rays to determine whether the vertebra is changing position.

Surgical Treatment

If the spondylolysis is severe, causing a slipped vertebra, then the team at OrthoNeuro may suggest minimal invasive spinal fusion.

During the procedure, the orthopedic surgeon will first realign the vertebrae in the lumbar spine. 

Then, with a bone graft, screws, and rods, the vertebral bodies will fuse together. This will also rectify spinal instability.

If high-grade forward slippage has occurred, there may be some compression of the spinal cord and its nerve roots.

The spine surgeon may then perform a procedure to open up the spinal canal and relieve pressure on the nerves before serving the spinal fusion.

If you live with chronic back or neck pain, contact Orthoneuro in Columbus, Ohio, for state-of-the-art diagnosis and personalized spine care treatment plans to heal your spine, relieve your pain, and help you get back to your regular activities.

Make an Appointment with an OrthoNeuro Spine Surgeon Today!

  • If you have been experiencing symptoms of spondylolysis, schedule an appointment with one of our Board Certified Spine Specialists at one of our 7 convenient locations throughout Greater Columbus. 
  • We will evaluate your unique lifestyle and goals to determine which type of treatment is best for you.

Meet Our Spine Team

Paul H. Eichenseer, DO

Orthopedic Spine Surgeon

David K. Kim, MD

Orthopedic Spine Surgeon

Donald J. Rohl, DO

Orthopedic Spine Surgeon

Larry T. Todd, DO

Orthopedic Spine Surgeon

Mark. A. White, DO

Neurosurgeon

Daniel P. Pap, MD

Interventional Pain Specialist

Dustin L. Reynolds, MD

Interventional Pain Specialist

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