Spondylolysis
What is Spondylolysis?
Spondylolysis is a condition when a child sustains a stress fracture to one of the vertebrae of the spine. It usually occurs at the 4th or 5th lumbar vertebrae in the low back.
How Does it Occur?
Spondylolysis can be caused by both hereditary factors and activity. A child who is born with thin vertebral bones may by at higher risk for developing spondylolysis. A child who is active in sports such as diving, gymnastics, football and any sport that puts stress on the low back due to hyperextension may develop spondylolysis over time.
What are the Symptoms?
A child may have spondylolysis and never even know it, but the most common complaint by the patient is low back pain.
How is it Diagnosed?
If your child is referred to an Orthopedic doctor for this condition, or with low back pain, a certain x-ray of the low back can confirm the diagnosis. This x-ray will show the stress fracture through the certain aspect of the vertebrae where it occurs.
What are the Treatments?
The treatment for spondylolysis is almost always conservative in nature. The child will be limited from his/her activities which cause the pain. Also, anti-inflammatory medications and physical therapy are usually recommended.
If spondylolysis is not treated or is diagnosed later, it may develop into spondylolisthesis.
Spondylolisthesis
What is spondylolisthesis?
Spondylolisthesis is a condition that occurs when there is a slip of the vertebra where a spondylolysis has previously occurred. The stress fracture may weaken to a point where there is a shift of the vertebrae, usually forward, from its normal position. It is possible if a large enough slip occurs that nerves may become pinched. Spondylolisthesis is graded from a mild slip (type 1) to a significant slip (type 5).
What are the symptoms?
A child that with spondylolisthesis may have pain and muscle spasms of the muscles of the lower back and back of the leg. These spasms may cause changes in the way a child walks. If there is a significant slip, nerves of the spinal column may become pinched.
How is it diagnosed?
Spondylolisthesis is diagnosed by a series of lumbar x-rays. The x-ray will allow the Orthopedic doctor to determine the amount of slippage that has occurred and what the treatment needs to be.
What are the treatments?
Treatment of spondylolistheisis is conservative if there is a minor slip of the vertebrae. This includes, rest from activities, anti-inflammatory medications, and physical therapy. A back brace may be recommended. If the slip is becoming worse, or the child has continued pain, then surgery may be needed. This surgery is referred to as a spinal fusion. During a spinal fusion the vertebrae of the low back (lumbar region) are fused to the sacrum.
