Spondylolysis is a stress fracture. It occurs in a part of the vertebrae (spinal bone). The pars interarticularis is a portion of the bone between the facets. There is a right and left section.
This condition occurs in the lower back. About 90% of the time it is in the lower back. It can fracture on one or both sides (bilateral). Left untreated, it can lead to spondylolisthesis. This is a more serious condition. The vertebra slips forward on the one below it. Both conditions can cause back pain.
This fracture is the most common cause of back pain in adolescent athletes.
Spondylolysis can be caused by:
Factors that increase the chance of spondylolysis:
Symptoms may include:
Many people have no symptoms at all.
The doctor will ask about your symptoms and medical history. A physical exam will be done.
Tests may include:
If you have symptoms, treatment may include:
Do not do athletic activities for several weeks to several months. In general, this restriction should last until the symptoms are gone.
Your doctor may suggest that you wear a back brace. This will help relieve pain. About 4-6 weeks of bracing may be needed. The brace should limit extension of the lower (lumbar) spine.
To relieve the pain and prevent recurrences, a physical therapist can teach you:
The doctor may give you medications for pain relief.
Surgery may be needed if there is:
Two procedures are usually needed:
To reduce your risk of getting spondylolysis:
American Academy of Orthopaedic Surgeons
American Academy of Pediatrics
Canadian Orthopaedic Association
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Herman MJ, Pizzutillo PD. Spondylolysis and spondylolisthesis in the child and adolescent: a new classification. Clinical Orthopaedics & Related Research . 2005;(434):46-54.
Low-risk stress fractures. American Journal of Sports Medicine . January 2001.
Peer KS, Fascione JM. Spondylolysis: a review and treatment approach. Orthopaedic Nursing . 2007;26(2):104-11.
Sakai T, Yamada H, Nakamura T, et al. Lumbar spinal disorders in patients with athetoid cerebral palsy: a clinical and biomechanical study. Spine . 2006;31(3):E66-70.
Last reviewed March 2013 by Teresa Briedwell, DPT, OCS
Last Updated: 3/15/2013