Spondylolysis is a stress fracture. It occurs in a part of the vertebrae (spinal bone).
This condition occurs in the lower back. About 90% of the time it is in the fifth lumbar vertebra. It can fracture on one or both sides. Left untreated, it can lead to spondylolisthesis. This is a more serious condition where 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.
Diagnosing Spondylolysis at UVA Health
The doctor will ask about your symptoms and medical history. A physical exam will be done.
Imaging tests to find the fracture and look for other problems in the soft tissue may include:
- CT scan
- Single photon emission computed tomography
- MRI scan
Spondylolysis Treatment at UVA Health
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:
- Exercises to strengthen the back and abdominal muscles — these muscles stabilize the spine.
- Proper exercise and sports techniques to help prevent overuse and further injury
- Hamstring stretches
The doctor may give you medications for pain relief.
Surgery may be needed if there is:
- Injury to the nerve
- High-grade spondylolisthesis (more than 50% slippage)
- No relief from medicine, rest, activity modification and physical therapy
Two procedures are usually needed:
- Decompressive laminectomy — removal of bone and tissue that are putting pressure on the spinal nerves
- Spinal fusion — fusing together of the two involved vertebrae to prevent further slippage of the vertebra