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Spondylolisthesis vs. Spondylolysis

Both conditions mentioned commonly cause low back pain in younger athletes.

Spondylolysis is a stress fracture occurring in one of the vertebrae.  This condition, as stated above, usually affects adolescents and even children who are involved in sports which exert pressure on the lumbar (lower spine).  For example, weightlifting, football and gymnastics.

While the two medical terms are similar, it’s spondylolysis which leads to spondylolisthesis.  The fractured vertebra involved becomes weakened to the point it’s unable to maintain its normal position.  This causes it to slip or shift.  It’s this slip or shift which results from the spondylolysis (fracture).

Usually, patients suffering from these related conditions experience pain and attendant symptoms which respond well to conservative therapies.  Refraining from sports activities and other physical challenges is part of the treatment.

But those patients who experience serious and persistent pain due to an acute vertebral shift may be candidates for corrective surgery.

What happens with spondylolysis?

The pars interarticularis is a small but integral part of the vertebrae.  It connects the upper and lower facet joints.

It’s usually the case that the fracture is seen in the fifth vertebra of the lower spine.  However, it may also occur in the fourth vertebra.  The fracture may manifest one or both sides of the bone.

The “weakest link” is one way to describe the pars interarticularis.  It’s the spinal component most likely to suffer from repetitive motion injuries and overuse.  And these are the most common sports-related injuries.

It’s a strange irony that young people are so prone to spondylolysis, although it’s seen in patients of all ages.  But young people, through adolescence are still growing, so their spines are especially prone to injury.

What’s worse is that the same cohort may also experience spondylolisthesis as a result of the original vertebral fracture.

And with spondylolisthesis?

When spondylolysis is left untreated, the pars interarticularis will separate.  This allows the vertebra to slip forward, contacting the vertebra directly underneath it.  This is most likely to happen during adolescent and childhood growth spurts.

The amount of slippage determines whether the spondylolisthesis is serious or minor, in nature.  When more than 50% of the vertebra’s width slips forward over the vertebra below it, the condition is deemed serious.  A slippage of this magnitude can be extremely painful and result in nerve damage, necessitating surgical intervention.

Diagnosis and treatment

Young people experiencing pain in the lower back should attend their primary giver for diagnostic imaging tests to discover the root cause of the pain.

Should either of spondylolysis or spondylolisthesis be detected, the first course of action will be conservative interventions, including rest, physical therapy and the prescription of non-steroidal anti-inflammatory drugs.  Bracing may also be prescribed to re-stabilize the spine.

In the event of a serious vertebral slippage, spinal fusion may be recommended.  This serves to relieve pain and stabilize the spine, preventing further slippage and deterioration.

CTSI – the spine people

Under the leadership of award-winning spine surgeon, Dr. Randall Dryer, Central Texas Spine Institute is dedicated to treating all conditions of the spine.  Contact us.