Spondylolysis

The spine is made up of small bones called vertebrae, which are stacked on top of one another. The bones connect to create a tube that protects the spinal cord. Spondylolysis is a common cause of low back pain in adolescents that is caused by a crack or stress fracture in one of the vertebrae. The injury most commonly occurs in the lower spine and can occur on one or both sides of the vertebrae.

Causes and Risk Factors

Spondylolysis is commonly seen in young athletes who participate in sports that involve ongoing stress on the back, such as gymnastics, football, or weight lifting. Spondylolysis can occur in people of all ages, but children and adolescents are most susceptible as their spines are still developing. Genetics may also play a role in spondylolysis. Some people are born with vertebrae that are thinner than usual, which may make them more vulnerable to fractures.

Symptoms

Many patients with spondylolysis do not have any symptoms. The condition may not be discovered until an x-ray is taken for an unrelated reason.

If symptoms are present, the most common are:

  • Back pain similar to muscle strain
  • Pain that radiates to the buttocks or back of the thighs
  • Pain worsens with activity and improves with rest

Treatment

For most children with spondylolysis, the condition will improve with conservative treatment. The first step is usually a period of rest from sports or other strenuous activities. Other nonsurgical treatment options include:

  • Anti-inflammatory medications to help reduce swelling and relieve pain
  • Physical therapy exercises to improve flexibility and strengthen muscles
  • Bracing to limit the movement of the spine and allow fractures to heal

Surgery is not required for spondylolysis, but may be necessary if the condition progresses into spondylolisthesis.