What is spondylolysis, and how is it treated?
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.
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.
After discussing your medical history, the orthopedic doctor will perform a physical examination of your back and spine, looking for:
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.
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:
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:
Throughout treatment, your doctor will take periodic x-rays to determine whether the vertebra is changing position.
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.
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.
Orthopedic Spine Surgeon
Interventional Pain Management Specialist
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