Spondylolysis is a disorder related to the development of a stress fracture in the lower vertebrae. It develops most commonly in adolescents (age 10 to 15). It can be a cause of low back pain, but the majority of adolescents with spondylolysis do not have symptoms, or their symptoms are mild and are often overlooked.
Spondylolysis is seen more often in athletes than in people who do not actively participate in sports, although studies differ as to just how much more. Approximately 3 to 7 percent of the general population is thought to have spondylolysis. It is suspected that spondylolysis occurs most frequently in young athletes who are involved in sports that require repeated hyperextension of the lower back (football lineman and gymnasts).
Symptoms of spondylolysis include:
- Pain in the lower back, especially with bending backwards.
- Pain directly over the spine.
- Relief of symptoms with forward bending.
Diagnosis can be made based on the history of injury as well as a physical exam. X-rays can confirm the presence of a stress fracture, but CT scans are more accurate. A CT scan may not be necessary to confirm the diagnosis before treatment is initiated.
Treatment is a period of rest from the offending activities and physical therapy. Symptoms will usually improve over a period of six to 12 weeks. Occasionally, surgery is indicated if conservative management fails to improve symptoms. Return to sport is permitted when pain is gone.