Sports Medicine: Spondylolysis and Spondylolisthesis
What are spondylolysis and spondylolisthesis injuries?
Spondylolysis and spondylolisthesis are types of injuries to the vertabrae. Pars defects, pars stress fractures or stress fractures are other names commonly used for Spondylolysis and spondylolisthesis.
Vertebrae have a solid portion called the body and a ring-like portion which protects the spinal cord. Spondylolysis is a condition in which there is a break in one or both sides of the ring-like portion of the vertebrae. Spondylolisthesis is a conditon in which both sides of the ring-like portion of the vertebrae are broken and the vertebral body is shifted forward, which can lead to complications involving nerve roots descending from the spinal cord.
What causes spondylolysis and spondylolisthesis injuries?
Spondylolysis and spondylolisthesis commonly affect the 4th and 5th lumbar (lower back) vertabrae. These conditions are caused by repetitive extension of the back. These conditions are often seen in gymnasts, cheerleaders and football players. When the lower back is extended repeatedly, structural changes may occur involving the ring-like portion of the vertebrae in susceptible individuals.
What are the symptoms of spondylolysis and spondylolisthesis injuries?
The symptoms vary depending on the athlete. Some athletes may have spondylolysis or spondylolisthesis and not have any symptoms at all. Others may experience lower back pain and/or muscle spasms during activity or, in some cases, continuously.
How are spondylolysis and spondylolisthesis injuries diagnosed?
A thorough history and physical examination will be used to diagnose spondylolysis or spondylolisthesis. The physician will also order x-rays to assist in their diagnosis. A bone-scan, CT or MRI may also be ordered to further evaluate the severity of the injury.
What is the treatment for spondylolysis and spondylolisthesis injuries?
Rest and activity modification may be required if the athlete is experiencing pain with activity. Anti-inflammatory treatment and rehabilitation may also be helpful in spondylolysis and spondylolisthesis injuries. Bracing may be an option for treatment in some individuals. In severe cases, surgery may be required to repair, or fuse, the vertebrae.
What is the long-term outlook for spondylolysis and spondylolisthesis injuries?
If caught early, and after proper treatment and rehabilitation, a full return to most activities may be expected. It is important to be pain-free and fully regain flexibility before returning to activity. After returning to activity a strengthening and flexibility program needs to be maintained.