Spondylolysis is a stress fracture of vertebra that may progress into spondylolisthesis, a condition of displacement of vertebrae from the spinal column. Spondylolysis is the cause for frequent low back pain in children. It is more common among children and teenagers who participate actively in sports such as football, weightlifting and gymnastics.
Spondylolysis occurs as a result of a defect or stress fracture in the pars interarticularis, the part of the lumbar spine joining the upper and lower joints. Genetic factors may have a role. Children born with thin vertebra are prone to vertebral stress fractures. Also, repetitive trauma to the lower back area that occurs during sports and other activities can cause weakness of the pars interarticularis, resulting in spondylolysis.
Although initially the patient may not have any symptoms, lower back pain is apparent during the teenage growth spurt period. The pain worsens with vigorous physical activities and exercises. At times, the pain may feel similar to a muscle strain.
Risk factors for developing spondylolysis include:
- Family history of back problems
- Repetitive trauma to the lower back
- Increased lordosis (swayback)
- Incomplete development of spinal cord (spina bifida occulta) and
- Participation in sports such as football, gymnastics and weight lifting that require constant overstretching of spine
Untreated spondylolysis may lead to further complications including:
- Spondylolisthesis, a condition where one or more vertebrae slips out of place
- Limited mobility and inactivity
- Weight gain because of inactivity
- Loss of bone density
- Loss of muscle strength
- Loss of flexibility
- Permanent nerve damage
- Chronic back pain
- Numbness, tingling or weakness in the legs
- Nerve compression causing problems with bowel or bladder control
Your surgeon diagnoses spondylolysis by asking several questions and performing several tests that includes:
- Family History
- Medical History
- Physical Examination
- CT scan or MRI scan
Primary treatment for spondylolysis is always conservative. The goal of the conservative treatment is to reduce the pain, allow the fracture to heal and improve the function.
Conservative treatment options include:
- Rest: Adequate rest should be taken and strenuous exercises should be avoided until the symptoms subside
- Medications: Non-steroidal anti-inflammatory drugs (NSAID’s) may be prescribed to reduce the pain and inflammation. If NSAID’s do not provide relief, epidural steroid injections may be administered to the spine to reduce pain, numbness and tingling in the legs
- Physical therapy: An exercise program helps to strengthen the abdominal and back muscles, improve flexibility and increase range of motion of the lower back
- Use of braces: In severe cases of spondylolysis, a brace or back support may be used to stabilize the lower back during fracture healing
Surgery is usually required if spondylolysis progressed into spondylolisthesis. The goal of the surgery is to remove any abnormal bone compressing a nerve and to stabilize the spine.
Decompressive Laminectomy & Spinal Fusion: In this procedure a portion of the bone or lamina imparting pressure on the nerves is removed. A surgical incision is made in the back, then part of the bone and thickened tissue pressing on the spinal nerves is removed. This allows more space for the nerves thus relieving pain and pressure. This procedure makes the spine unstable and therefore spinal fusion will be performed to stabilize the spine.
Spinal fusion is the procedure of joining two adjacent vertebrae. During the procedure a piece of bone, taken from elsewhere in the body or donated from a bone bank, is transplanted between the adjacent vertebrae. As healing occurs, the transplanted bone fuses with the spine. This stimulates growth of a solid mass of bone which helps to stabilize the spine. In some cases, metal implants such as rods, hooks, wires, plates or screws are used to hold the vertebra firm until the new bone grows between them.
Although spondylolysis is not completely preventable, certain factors can reduce the risk of developing the condition:
- Maintaining a healthy weight to reduce stress on the lower back
- Core exercises to keep the abdominal and back muscles strong will help to support the lower back
- Eating a well-balanced diet to keep your bones strong
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Houston Neck and Spine Specialists
Advanced Orthopedics and sports medicine has Board Certified/Eligible physicians who are thoroughly educated in the latest treatment techniques both surgical and conservative. The spine surgeons practice conservatively utilizing minimally invasive techniques whenever possible. Should surgery be required, options range from out-patient spinal surgery to major spinal reconstruction and management of scoliosis.
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What Our Patients Are Saying
Each procedure done by Dr. Patel has been an improvement. Very pleased.
Dr. Patel has been a great Doctor for me. When I was referred to after discussion we decided to do injections in my back. The first two did not work so did two more in a different section of my back. These injections worked great. I’m now able to sleep at night and the numbness in my foot is almost gone. The tingling in my foot & leg is gone and I am very happy about that. I am extremely happy that Dr. Patel is my Doctor. She has been a good listener when I tell her where I hurt and talks to me about what she feels should be done. The final decision is always mine.
On Nov. 22, 2017, I had a spinal injection in my lower back and it was an instant miracle in my life! For the first time in 4 intolerable months of pain, I was finally pain free, and I am now getting a second chance to live again! I am so grateful to Dr. Patel for my new life, and to God for guiding me to her! Thank you so very much Dr. Patel – you are God’s gift to me, thank you for being so awesome at what you do.
Dr. Patel is one of the best Doctors I have ever had. She is pretty good at her job. She makes it plain and simple. She is also very thoughtful. I was very glad to have met her. In other words she is pretty good.
The surgery done by Dr. S. Patel (Actually injections) & the mild medications she has prescribed has surely made my lower back -hip-leg less painful. I have complete confidence in her medical judgement & advice. She will administer second injection in June.
Dr. Patel is a very good Pain Management Doctor. She is one of my favorite doctors.
Dr. Patel has been great at my pain relief. She doesn’t force me to take any meds I don’t want, or injections. She will give me the injection I want when I need it. Great friendly Doctor.
Thank you for the opportunity to express how pleased I am with the excellent care of Stacy A. Bacon, M.D. I have confidence in her ability to care for me as she successfully partially replaced a broken hip 10 years ago, 2007. I also want to compliment Cheryl who set up the appointment. She represents Advanced Orthopaedics & Sports Medicine very well.
It’s been over 8 years since Dr. Bacon replaced by right ankle. I still can’t thank her enough for the years of pain free walking I have done since! And I’m still going strong! I had numerous breaks in my ankle due an auto accident, repaired/set by a different doctor, after multiple surgery’s, I was still limping, in great pain every day. Then I found Dr. Bacon, now, no more pain, NONE, and no more limping after this ankle replacement. I rave about her constantly and would recommend her to anyone who has a foot or ankle issue
I had been in so much pain with my back for years. It got so bad that I knew I had to do something. I went to Dr Mohr for help. I was so afraid to have spine surgery as I had heard so many horror stories. He and his staff were very informative. I was amazed at the new technology in spinal surgery. December 8, 2016 I had rods and pins put in my back. I am so happy I did now. I am healing really fast and the pain is going away as my body heals. Thank you Dr Mohr for you expertise and sensitive nature. You were understanding about my fear and helped assure me so I could receive the help I needed. You are an excellent Doctor.