Spondylolysis is a problem that develops among the vertebrae — the bones that help make up the spine. The condition actually develops in the pars interarticularis — the connection between the vertebrae. These connections are what allow the spine to curve and bend. Most cases of spondylolysis develop in the lower lumbar vertebrae, but it can develop higher in the back, and even in the thoracic vertebrae.
It is difficult to know what causes spondylolysis, but it is most commonly diagnosed in teenagers around the age of 15 or 16, and is most often seen towards the end of a rapid growth spurt. It is the most common cause for lower back pain in young adults. While doctors often have trouble pinpointing the exact cause of spondylolysis, there are some behaviors that increase the likelihood of developing the condition. Some cases of spondylolysis occur as the result of stress on the vertebrae. This is common for teens that participate in sports such as weight lifting, gymnastics or dance. Other cases are linked to genetics. While three to six percent of the general population of the US are diagnosed with spondylolysis, the number climbs to over 30 percent for American Eskimos.
Spondylolsis is difficult to diagnose. Often, the initial diagnosis is a muscle spasm. The first symptom felt is typically lower back pain. The pain grows worse with activity or exercise. If the condition continues untreated, the disc may slip out of place, causing a condition known as spondylolisthesis. This is when the damage to the pars interarticularis is so severe that the vertebrae actually becomes displaced, or turns on its side.
For an accurate diagnosis, a physician will perform an x-ray, MRI or CT scan on the area of the back that is experiencing pain. MRIs and CTs are more effective diagnostic tools because they can detect fractures that are too small to show up on an x-ray, and are also effective at ruling out a pinched nerve or bulging disk, two other common causes of back pain.
Once a diagnosis is made, treatment is relatively straight forward. The aim of treatment is to reduce pain and allow the bone to heal. Rest and pain relievers are often prescribed. If the pain is too severe to be helped by over the counter pain relievers, the physician may prescribe a stronger medication. In severe cases, an epidural steroid is given to reduce inflammation in the area and relieve pain. To prevent re-injury, the patient may be required to wear a back support and may also participate in physical therapy.