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Spondylolysis/Spondylolisthesis

Spondylolysis and spondylolisthesis are two different but related conditions that refer to defects in the vertebrae, the bones that make up the spine. Spondylolysis is a fracture of the thin parts of the vertebrae that link the front and back together. If that fracture separates it allows the vertebra to slip called a spondylolisthesis. Both conditions are common causes of low back pain, particularly in young athletes who play sports that place stress on the lower back.

Spondylolysis/Spondylolisthesis Hero Image 2

Spondylolysis (spon-dee-low-lye-sis) and spondylolisthesis (spon-dee-low-lis-thee-sis) are two different but related conditions that refer to defects in the vertebrae, the bones that make up the spine. Spondylolysis is a fracture of the thin parts of the vertebrae that link them together. Spondylolisthesis is an injury that happens when a vertebra becomes so weak that it slips out of its place in the spine. Both conditions are common causes of low back pain, particularly in young athletes who play sports that place stress on the lower back.

What causes Spondylolysis/Spondylolisthesis?

Spondylolysis and spondylolisthesis are typically caused by playing sports that require repetitive overstretching (called hyperextension), such as football or soccer. Younger athletes are at greater risk for these injuries because their spines are still developing. Genetics may cause some people to have thinner vertebrae, making them susceptible to these injuries. An acute trauma to the lower back can also be a cause.

Spondylolysis and spondylolisthesis are most common in these sports:

• Soccer
• Diving
• Gymnastics
• Football
• Weightlifting

Symptoms

The most common symptom of these injuries is low back pain, but for some people, there may be no symptoms at all. Young athletes with spondylolysis or spondylolisthesis usually see symptoms around the age of 15-16. Common symptoms also include:

• Pain in the lower back that feels like a muscle strain
• Pain that spreads to the buttocks and thighs
• Pain that gets worse with physical activity

Athletes with severe slippage of the vertebrae (spondylolisthesis) may experience tingling or numbness due to pressure on the nerves.

When to see a doctor

You should bring your child to their doctor if they experience low back pain or related symptoms, or suffer an acute injury to their lower back. The doctor will first want to know about their physical activities. During a physical examination, he or she will look for signs of tenderness and test their range of movement. They may look to see if there are any issues with your child’s gait or how they stand. X-rays or other imaging tests may be taken to see confirm if there is a fracture of a vertebra. Imaging tests also help doctors evaluate how much slippage has occurred, which they often describe as “low grade” or “high grade.”

Non-operative treatment

Non-operative treatment is usually effective for cases of spondylolysis and low grade spondylolisthesis. Examples of conservative treatment include:

• Rest from sports that place stress on the back
• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, for pain relief
• Wearing a back brace to limit movement and promote healing of the muscles and bones of the lower back
• Physical therapy for muscle stretching and strengthening

You can also try these exercises at home:

[List and link to exercises listed on the website here]

Surgical Treatment

Your doctor may recommend a surgical procedure if your child has high grade spondylolisthesis or if conservative measures are not effective in relieving symptoms. Your doctor will advise if surgery is an option you should consider.

Recovery

Most athletes recover well from spondylolysis and spondylolisthesis. They can expect to return to playing their sport when symptoms have resolved and they have regained a full range of motion. Doctors may recommend a gradual return to play, with strengthening exercises and follow-up visits to ensure a full recovery.

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