Causes and Symptoms of Spondylolysis:

Spondylolysis happens when a crack forms in the bony ring on the back of the spinal column. Most commonly, this occurs in the low back. In this condition, the bone that protects the spinal cord fractures as a result of excessive or repeated strain. The area affected is called the pars interarticularis, so doctors sometimes refer to this condition as a pars defect.

This condition appears in six percent of children. It mainly affects young athletes who participate in sports in which the spine is repeatedly bent backwards, such as gymnastics, football, and karate.

Anatomy

The human spine is made up of 24 spinal bones, called vertebrae. Vertebrae are stacked on top of one another to create the spinal column. The spinal column gives the body its form. It is the body’s main upright support. The section of spine in the lower back is called the lumbar spine.

Each vertebra is formed by a round block of bone, called a vertebral body. A circle of bone attaches to the back of the vertebra. When the vertebrae are stacked on top of each other, these bony rings create a hollow tube. This tube, called the spinal canal, surrounds the spinal cord as it passes through the spine. Just as the skull protects the brain, the bones of the spinal column protect the spinal cord.

Causes of Lumbar Spondylolysis

Spondylolysis is thought to be caused by repeated strains that damage the lower spine over time. The repeated strains can eventually lead to an overuse injury in the pars interarticularis. The most common location for this to occur is in the lowest vertebra of the spine. This vertebra connects the spine to the pelvis. However, a problem with the pars can occur in any lumbar vertebra. It rarely happens in more than one vertebra at a time.

• The vertebra initially responds to the abnormal strain by adding new bone cells around the injured area.
• But if the injuries happen faster than the body can keep up with needed repairs, a crack may form in the weakened bone. This is called a stress fracture.
• This type of fracture occurs in the pars, the area of bony ring between the pedicle and lamina.
• The crack may affect only one side of the bony ring. However, it is equally common for the defect to occur on both sides.
• When this happens, the vertebra is no longer held firmly in place by the facet joints on the back of the ring.
• As a result, the vertebra is free to slip forward over the one below.
• This slippage, which is closely related to spondylolysis, is called spondylolisthesis.

Symptoms

1. People with spondylolysis may feel pain and stiffness in the center of the low back.
2. Bending fully backward increases pain.
3. Symptoms typically get worse with activity and go away with rest.
4. Doctors refer to this type of back pain as mechanical pain because it most likely comes from excess movement between the vertebrae.
5. Individuals may eventually experience pain that radiates down one or both legs.
6. This pain may come from pressure and irritation on the nerves that exit the spinal canal near the fracture.
7. When nerve pressure in the low back causes leg pain, doctors refer it as neurogenic pain.

Treatment

• Recovery from this condition is much like nonsurgical treatment mentioned earlier.
• Once you have rested your back to allow it to heal, your doctor may recommend that you work with a physical therapist a few times each week for four to six weeks.
• In severe cases, patients may need a few additional weeks of physical therapy.

Active’s friendly staff looks forward to assisting you in making your appointment in any of our clinics. Please do not hesitate to contact us, we are dedicated to providing the best physical therapy service in Maryland.