What are the other Names for this Condition? (Also known as/Synonyms)

• Defect of the Pars Interarticularis
• Disruption of the Pars Interarticularis
• Spondylolysis (Disorder)

What is Spondylolysis? (Definition/Background Information)

• Spondylolysis is a small microfracture that occurs in a part of the vertebral bones within the spinal column, commonly at the pars interarticularis (a bony bridge in the vertebra)
• Spondylolysis mostly affects the fifth lumbar vertebra, within the lower back. Sometimes, this condition may also affect the fourth lumbar vertebra
• Over time, as a result of the microfracture (which may be acquired or developmental), the neighboring vertebra may slip, resulting in a condition called spondylolisthesis

Who gets Spondylolysis? (Age and Sex Distribution)

• Individuals of all gender, age, and racial/ethnic groups, may develop Spondylolysis
• Men are 2-4 times more like to develop Spondylolysis than women, especially among athletes, who participate in rough or high-impact sports
• Spondylolysis is a very common condition. Various studies estimate that about 9 in 10 adults will experience some degree of Spondylolysis, by the time they reach 60 years old. However, a majority of them will not have any noticeable signs or symptoms

What are the Risk Factors for Spondylolysis? (Predisposing Factors)

Common risk factors associated with Spondylolysis include:

• Rough or high-impact sports associated with athletics
• Repetitive overuse of a spine associated with sports, certain occupation
• An advancing age
• A collection of abnormal birth defects called spina bifida occulta
• Individuals who have an immediate family member or relative with a history of Spondylolysis are at an increased risk
• Postmenopausal women, or inactive older individuals with a degenerative joint disease (such as osteoporosis)
• Poor posture
• Certain occupations that require excessive lifting of heavy objects
• Pregnant women
• Rapid growth in adolescents

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Spondylolysis? (Etiology)

Some of the causes associated with Spondylolysis include:

• Genetic factor that results in an abnormally thin vertebrae
• Performing highly stressful activities, which affect the spine (may be related to sports or work)

What are the Signs and Symptoms of Spondylolysis?

Signs and symptoms of Spondylolysis include:

• Excessive pain and stiffness in the lower back
• Excessive pain that radiates down one or both legs
• Pain while exercising

How is Spondylolysis Diagnosed?

Diagnostic methods that a physician may use to help diagnose Spondylolysis include:

• Physical examination: The physician will perform a thorough physician examination to determine if the individual has Spondylolysis. In addition to this, the individual’s medical history shall be evaluated
• X-ray of the lower back: An X-ray is a diagnostic test that may show the presence of any vertebral fracture within the lower back
• MRI and CT scan of the lower back: These tests help identify small fractures within the lower back, or in ruling out other conditions that may be associated with back pain, such as a herniated disc, or a pinched nerve
• Bone scan: A bone scan is used to locate any bone abnormalities by injecting tiny amounts of radioactive material into the bloodstream

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Spondylolysis?

Complications associated with Spondylolysis include:

• Possible weight gain due to decreased physical activity
• Chronic pain and stiffness within the lower back
• Vertebrae within the back, slips out of its normal position (causing spondylolisthesis)

How is Spondylolysis Treated?

The initial treatment measures associated with Spondylolysis are normally conservative, with a primary focus on relieving the symptoms that cause pain and stiffness. These are:

• Wearing a specialized back brace can help rest the back muscles and decrease the range of motion. This aids by reducing the irritation caused to the nerves in the neck
• Non-steroidal anti-inflammatory oral medications may be used to help decrease the pain and swelling
• Corticosteroid injections into the epidural space (region near the spine, inside the vertebral column) help provide temporary relief of symptoms, and in improving the range of motion. It is important to note that corticosteroid injections only give temporary relief. Prolonged episodes of such injections, may injure the joints in the long-run
• Physical therapy exercises that include strengthening and improving flexibility of the back, can help reduce discomfort

Surgical treatment for Spondylolysis may be recommended, if an individual does not respond to conservative management of the condition. Individuals are advised to discuss alternatives with their physicians, before making a decision.

Common surgical procedures that help decrease compression of the spinal cord include:

• Lumbar laminectomy: This surgical procedure is intended to relieve pressure on the spinal cord and/or nerves by removing the lamina. During a lumbar laminectomy procedure, the lamina (small section of the bony roof in the spine) is removed to create additional space for the surrounding nerves within the spinal canal. A bone graft material then fills the empty space and two or more vertebrae of the lumbar spine are fused together to create stability. However, this procedure may also be performed, without a lumbar spinal fusion
• Anterior lumbar interbody fusion (ALIF): This surgical procedure is performed from the front through an abdominal incision. It involves the removal of damaged or diseased intervertebral bone and the surrounding lumbar discs. A bone graft material is then used to fill the empty space, and it is fused together with the lumbar spine

How can Spondylolysis be Prevented?

Spondylolysis disorder is a condition that is extremely difficult to prevent, due to a variety of risk factors being involved. However, observing certain preventive guidelines may help decrease the risk of development of the condition. These include:

• Exercising regularly
• Begin any new physical activity slowly, with a thorough and complete warm-up. Individuals are advised to add low-impact activities to their exercise regimen to avoid repetitiveness
• Individuals, who participate in any rough, high-impact sports (like football), should wear appropriate safety equipment to help decrease the risk of developing Spondylolysis
• Maintain correct posture while standing, sitting, or working at a desk (or on the computer)
• Individuals are advised to seek medical attention if chronic back pain develops
• Adequate rest between exercises, can help prevent injuries due to overuse
• Maintaining a healthy body weight can help reduce unwanted stress on the spine

What is the Prognosis of Spondylolysis? (Outcomes/Resolutions)

• The long-term prognosis with Spondylolysis depends on the severity of the degenerative disorder an individual develops
• If the cause of Spondylolysis is detected early, and aggressive treatment provided, the quality of life can be substantially improved. This also helps avoid any serious complications from arising in the neck
• Some individuals with the disorder are able to have a productive life. In others, this disorder may become debilitating and they may experience a gradual degeneration of the bones and cartilage within the neck, during their lifetime

Additional and Relevant Useful Information for Spondylolysis:

Spondylolisthesis is an extremely painful and traumatic injury that involves a vertebra in the spine, which slips forward out of its normal position, resulting in abnormal pressure on the nerve roots.