...less medical jargon in a 'Quick Glance' format!
Spondylolysis: The most common cause of low back pain in adolescent athletes that can be seen on X-ray is a stress fracture in one of the vertebraes that make up the spinal column. It usually affects the fifth lumbar vertebra in the lower back and, much less commonly, the fourth lumbar vertebra.
Symptoms:
Neck pain
Pain spreading from neck down arms
Lumbar pain
Lower back pain
Leg pain
Arm pain
Stiff neck
Stiff lumbar region
Muscle weakness
Arm weakness
Movement difficulty
Muscle spasms around the spine
In cases of extensive slipping the torso is shortened, the ribs may rest on the iliac crests, and the abdomen may protrude. In severe cases, the pelvic inclination is decreased and the body is swayed backward.
Cause:
. . . Genetics
There may be a hereditary aspect to spondylolysis. An individual may be born with thin vertebral bone and therefore may be vulnerable to this condition. Significant periods of rapid growth may encourage slippage.
. . . Overuse
Some sports, such as gymnastics, weight lifting, and football, put a great deal of stress on the bones in the lower back. They also require that the athlete constantly overstretch the spine. In either case, the result is a stress fracture on one or both sides of the vertebra.
In many people, spondylolysis and spondylolisthesis are present, but without any obvious symptoms.
Pain usually spreads across the lower back and may feel like a muscle strain.
Spondylolisthesis can cause spasms that stiffen the back and tighten the hamstring muscles, resulting in changes to posture and gait. If the slippage is significant, it may begin to compress the nerves and narrow the spinal canal.
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Treatment:
. . . Nonsurgical Treatment
Initial treatment for spondylolysis is always nonsurgical. The individual should take a break from the activities until symptoms go away, as they often do. Anti-inflammatory medications, such as ibuprofen, may help reduce back pain.
Occasionally, a back brace and physical therapy may be recommended. In most cases, activities can be resumed gradually and there will be few complications or recurrences. Stretching and strengthening exercises for the back and abdominal muscles can help prevent future recurrences of pain.
Periodic X-rays will show whether the vertebra is changing position.
. . . Surgical Treatment
Surgery may be needed if slippage progressively worsens or if back pain does not respond to nonsurgical treatment and begins to interfere with activities of daily living. A spinal fusion is performed between the lumbar vertebra and the sacrum. Sometimes, an internal brace of screws and rods is used to hold together the vertebra as the fusion.
