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Spondylolysis is a stress fracture. It occurs in a part of the vertebrae (spinal bone). The pars interarticularis is a portion of the bone between the facets. There is a right and left section.
This condition occurs in the lower back. About 90% of the time it is in the fifth lumbar vertebra. It can fracture on one or both sides (bilateral). Left untreated, it can lead to spondylolisthesis. This is a more serious condition. The vertebra slips forward on the one below it. Both conditions can cause back pain.
This fracture is the most common cause of back pain in adolescent athletes.
Spondylolysis can be caused by:
- Congenital defect in the spine (usually appears a few years after birth)
- Acute trauma to the back
- Degenerative conditions of the spine
Factors that increase the chance of spondylolysis:
- Playing sports (eg, gymnastics, football [especially the offensive line], diving, wrestling, weightlifting)
- Improper athletic or exercise technique
- Adolescent growth spurt
- Chronic overextension (bending backwards) with or without side bending of the back (common in certain sports and activities)
- Hamstring tightness or muscle imbalance
- Cerebral palsy (less common)
Symptoms may include:
- Pain across the lower back
- Spasms in the back and hamstring muscles
- Pain radiating down the leg
Many people have no symptoms at all.
The doctor will ask about your symptoms and medical history. A physical exam will be done.
Imaging tests to find the fracture and look for other problems in the soft tissue may include:
If you have symptoms, treatment may include:
Do not do athletic activities for several weeks to several months. In general, this restriction should last until the symptoms are gone.
Your doctor may suggest that you wear a back brace. This will help relieve pain. About 4-6 weeks of bracing ma