What is Spondylolysis

Spondylolysis is defined as a defect in the pars interarticularis of the vertebral arch.The great majority of cases occur in the lowest of the lumbar vertebrae (L5), but spondylolysis may also occur in the other lumbar vertebrae, as well as in the thoracic vertebrae.

Signs and symptoms

Spondylolysis pain can lead to reduced mobility and inactivity. Inactivity can result in weight gain, loss of bone density, and loss of muscle strength and flexibility of other areas of the body. Spondylolysis can progress until one or more vertebrae slip out of place which is then called spondylolisthesis.

Over time, degenerative changes of spondylolysis can cause serious complications including like low back, mid back, and neck pain, spinal Stenosis (where the spinal canal becomes narrow and the spinal cord can become pinched; can occur in the neck or low back), Cauda equina syndrome (a syndrome where the nerves at the bottom of the spinal cord are compressed by an intervertebral disc or mass), Radiculopathy ( a condition where one or more spinal nerves are compressed) and Spinal Myelopathy.

Pathophysiology

Spondylolysis is a defect of the lumbar vertebra in the spinal column. When spondylolysis is present in the spine, it means that the pars interarticularis is detached and there is a separation of the joints.

It is typically caused by stress fracture of the bone, and is especially common in adolescents who overtrain in activities.

Treatment

Rehabilitation and surgery are the two methods of management in conventional therapy. The most notable non-surgical rehabilitation procedure done with an individual with spondylolysis is Physical Therapy. Therapy usually ranges from 3 to 6 months depending on the status of the injury. Besides this, treatments for acute spondylolysis include resting from sports participation or wearing an anti-lordotic brace.

Medication such as ibuprofen and other pain relievers may also be used during these treatments to reduce the pain and decrease inflammation. During treatment, the patient is usually asked to stay off their feet and get as much rest as they can by lying down for the majority of the day. If for any reason the patient should do any sort of activity, the brace should be worn to prevent any excessive movement.

Surgery may be done to those who have not had success with treatments but this is not common.There are two types of surgery for this condition. Laminectomy (This is a procedure to remove the lamina from the bony ring of the vertebra and release pressure) and Posterior Lumbar Fusion. (Spinal fusion is a procedure that joins two or more bones (vertebrae) together into one solid one which will prevent the joints and bones from moving. Surgeons apply metal screws, and rods to hold the bones securely while they fuse).