Often occurring in the lower back area, spondylolysis is a stress fracture or crack in a spinal bone or vertebra. Specifically, it affects a part of the vertebral arch that joins two vertebrae via their connecting joints (facet joints). This small segment of bone is referred to as the pars interarticularis. Because this is the area that’s often affected, spondylolysis is sometimes described as a pars defect. Here’s what you need to know about its symptoms, diagnosis, and treatment.
How Can You Tell if You Have Spondylolysis?
Sometimes you can’t. Tiny spinal bone breaks may produce few or no symptoms. If you do have symptoms, the most common one is back pain within the affected area. If your neck is affected (cervical spondylolysis), you may notice neck pain and stiffness. When the lower back is affected, pain may extend downward to your buttocks or thighs. Arching your spine and certain other movements could also trigger discomfort.
The natural curvature of the human spine puts stress on the pars interarticularis during simple acts like walking. However, excessive stress may be placed on spinal bones and joints to the point where a fracture develops because of repetitive movements. Risk factors specifically associated with pars defects include:
- Repetitive backward bending, like what’s common with gymnastics
- The type of contact associated with sports like football and soccer
- Genetics (e.g., having a family history of spinal stress fractures due to inherited bone defects)
- Excess weight
How Is a Diagnosis Made?
Because chronic neck or lower back pain can have several possible sources, diagnosis usually involves image tests. Typically, an X-ray is all that’s needed to positively determine if you have a spinal stress fracture. If your discomfort continues even with initial physical therapy efforts, your Los Angeles spine surgeon may order additional tests, some of which could include:
• An MRI scan
• A CT scan
• A specialized test called a nuclear medicine bone scan combined with a single photon emission computed tomography (SPECT) of the lumbar spine if your lower back is affected
What Can Be Done to Treat a Pars Defect?
Normally, spondylolysis isn’t directly associated with nerve irritation or spinal cord damage, which is why affected individuals often respond well to conservative (nonsurgical) efforts. Treatment recommendations of this nature typically include:
- A temporary break/rest from sports and other strenuous activities
- Anti-inflammatory drugs, including over-the-counter options
- A combination of muscle strengthening and general conditioning exercises
- Use of a lumbar brace if your lower back is affected
Since spinal stress fractures are small, they tend to heal without surgery. However, if the fracture is severe or affecting the lower back area (lumbar spondylolysis) of a younger or otherwise healthy patient, surgery may be recommended. One procedure is done with the use of a titanium screw and a bone graft to support the repair. In some cases, if the pars defect also caused a vertebra to slip forward, the doctor may recommend spinal fusion surgery. Los Angeles patients who have this type of procedure are usually back home the same day or within a day or two.
If you suspect you may have spondylolysis or you have questions or concerns about your spinal health, the industry-leading professionals at The Spine Institute are here to help. Our spine experts are pioneers in every aspect of spine care, including prevention, nonsurgical treatment, and state-of-the-art surgical techniques. Call one of our friendly representatives today at 310-828-7757 to schedule a consultation.