Spondylolysis & Spondylolisthesis

Overview

What is Spondylolysis?

Spondylolysis is a condition when the fifth (last) vertebra of the lumbar (lower) spine is fractured.

What is Spondylolisthesis?

Spondylolisthesis is a condition when the spondylolysis (fracture of the fifth lumbar vertebra) weakens the bone so much that it cannot maintain proper position and vertebrae start to shift out of place.

Who is affected by Spondylolysis and Spondylolisthesis?

Adolescent athletes, especially football players, gymnasts and weight lifters, are prone to spondylolysis. Sports that require athletes to put a great deal of stress on their lower backs, and athletes that are required to constantly overextend their back are more prone to spondylolysis.

Symptoms

Symptoms of spondylolysis and spondylolisthesis often do not present right away, and when they do present, it can feel like muscle strain across the lower back. Spondylolisthesis can also cause muscle spasms.

Diagnosis

After taking a medical history and performing a thorough physical exam, your doctor probably will request that you have an x-ray, CT scan or an MRI scan, which will be able to show the spondylolysis or spondylolisthesis.

Treatment

Nonsurgical treatment

For most people with spondylolysis or spondylolisthesis, your doctor will try nonsurgical treatments first. Resting and taking a break from any sports or other physical activities is a good idea to give the fracture time to heal. Your doctor also might recommend physical therapy and exercise to strengthen muscles in your back and abdomen, which can help stabilize your spine. Anti-inflammatory medications (like ibuprofen) may be recommended to reduce pain, discomfort and inflammation.

In more severe cases, a back brace or back support might be used to stabilize the spine. And epidural steroid injections can help reduce inflammation and pain. The steroid is injected into the space surrounding the spine.

Surgical treatment

Surgery may be recommended if none of the nonsurgical treatment options help keep the pain at a tolerable level. Surgery for spondylolisthesis typically is a spinal fusion and sometimes involves screws and rods to hold everything together as the fusion heals. Another type of surgery that is used sometimes is called a vertebral body replacement.