Spondylolysis and Spondylolisthesis
One of the most common causes of lower back pain in adolescents who are
involved in athletics is a stress
fracture of the vertebra in the lumbar region of the spine, which can be
seen on an x-ray. The stress fracture(s) in this particular region of
the spine is known as spondylolysis.
If the stress fracture weakens the vertebra so much that it cannot support
or maintain it's proper position, shifting them out of place, it is
no longer spondylolysis, but another condition -- spondylolisthesis. It
is likely that the shifting of these vertebras can press on the spinal
nerves, causing pain and a limited amount of motor function such that
surgery may be required to correct the condition.
Your physician will conduct a physical examination to determine where in
the lower back the tenderness and pain occur. Then, he or she may order
an x-ray of your lower back to view the position of the vertebra in the
lumbar spine to confirm that there are fractures of slippage, confirming
the diagnosis of spondylolysis (for fractures) or spondylolisthesis (shifting
of vertebra forward).
In a posterior cervical foraminotomy, your physician will, from the back
of the neck, relieve the pressure on the spinal nerves by cutting or shaving
away parts of the open to open the nerve root opening (foramen) in the
lumbar area, where the spinal nerves branch out to the lower extremities.
A laminectomy removes the lamina, two small bones that make up a vertebra.
This is another procedure that is used to relieve pressure placed on the
spinal nerves. By removing the bones, more space is created in the spinal
column, giving the nerves more room.
A spinal fusion may be performed after aforaminotomy or a laminectomy to
further stability. This surgery will fuse together two vertebral bones
together, one on top of another, so that there is no longer any movement
between them. This fusion can be done with screws, plates, or cages. Depending
on your individual medical history and current health status, our spine
recommend an artificial disc replacement instead of a spinal fusion.
Individuals who develop these conditions may have been born with a thin
vertebrae that is susceptible to stress fractures
Periods of rapid growth can also put pressure on the vertebrae, increasing
the risk of stress fractures
Participating in some sports, can put a tremendous amount of stress on
the bones in the lower back. These include: ballet, gymnastics, lifting
weights, and contact sports.
- Stress fractures seen in spondylolysis are due to constant flexing or overstretching
of the spine.
- Many who have spondylolysis and spondylolisthesis do not exhibit any obvious symptoms.
- Pain usually spreads across the lower back and may feel like a muscle strain.
- Spondylolisthesis can cause spasms that stiffen the back and tighten the
- This can change your posture and gait.
Physicians seek to treat spondylolysisnon surgically before resorting to
Your physician will recommend that you take a break from your normal activities
and suggest that you take anti-inflammatory medications that may reduce
your back pain.
A back brace or physical therapy may be recommended by your physician.
Stretching and strengthening exercises for the back and abdominals can
help prevent future injuries.
This surgery will fuse together two vertebral bones together, one on top
of another, so that there is no longer any movement between them. This
fusion can be done with screws, plates, or cages. Depending on your individual
medical history and current health status, our spine specialists may recommend
an artificial disc replacement instead of a spinal fusion.