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Award-winning, internationally recognized care at Shriners Children's helps young athletes.

Spondylolysis is a stress fracture in the lower back. Children and teens who participate in sports that put repetitive stress on the lower back, such as gymnastics, basketball, skiing and weightlifting, are at highest risk. Some children are born with a genetic tendency to develop spondylolysis even if they do not participate in sports.

If left untreated, spondylolysis can progress to spondylolisthesis, a condition in which a vertebra, weakened by fracture, slips out of alignment with the rest of the spine. The risk of spondylolysis is higher during growth spurts.

Your Shriners Children's physician will perform a thorough history and physical exam, request X-rays be taken and discuss the details of your child's condition with you. Together, you will develop a personalized treatment plan that may include observation, temporary limits on physical activity, bracing, physical therapy or surgery.

Athletes with either condition can usually return to sports after several months of rest and physical therapy. Your child may need to wear a back brace as part of their recovery. If a vertebra is severely out of alignment, or if your child remains in pain despite other forms of treatment, they may need spinal fusion surgery, although the need for this is rare.

Specific treatments and services may vary by location. Please contact a specific location for more information.

Spondylosis vs. Spondylolysis vs. Spondylolisthesis

Three Similar Words – Three Different Conditions

Spondylolysis is different from spondylosis and spondylolisthesis. Spondylosis occurs when cartilage, disks, ligaments and bones in your child's neck wear down. Poor posture, obesity and lack of exercise can enhance the problem.

Spondyolysis is a stress fracture in the lower back. Repetitive stress from sports can put kids at risk. Both spondyolysis and spondylolisthesis may cause low back pain.

Spondylolisthesis happens when a vertebra, weakened from a stress fracture, moves forward, slipping out of alignment from the rest of the spine.

What Causes Spondylolysis?

Repetitive Stress

Most cases of spondylolysis are repetitive stress injuries that develop during intense athletic training. Athletes who participate in sports that put repeated pressure on the lower back are particularly prone to these overuse injuries of the spine. As the athlete’s muscles become overly fatigued, the load is transferred to their bones. Over time, the continued pressure can cause stress fractures in the lower spine.

Genetic Causes

Some children are born with fragile spines that can fracture in the course of normal childhood activities. These children may have lower spine fractures by the age of 5 or 6, usually with no signs or symptoms. Typically, they are diagnosed only if their doctor orders an X-ray for another back issue.

What are the Symptoms of Spondylolysis?

Spondylolysis is one of the most common causes of low back pain in young athletes. The degree of pain depends, in part, on the severity of the injury.

Symptoms of spondylolysis include:

  • Low back pain that increases during physical activity
  • Pain that spreads to the buttocks and down the back of the thighs
  • Tight hamstrings

Back pain caused by spondylolysis tends to progress in stages, starting out mild and gradually becoming more persistent. In severe cases, the pain can become constant, even when your child is not active.

It’s important to note that low back pain is often a symptom of muscle strain, not a fracture. Either way, if your child has low back pain, request an appointment to see a Shriners Children's physician. Prompt treatment can help resolve your child's pain and prevent the injury from progressing.

Your First Appointment: What to Expect

Our philosophy is to focus on all the options for your child. Your Shriners Children's physician will perform a thorough history and physical examination, order X-rays taken and go over the details of your child's condition.

Then, you and your physician will develop a personalized treatment program for your child. This plan may include medication, steroid injections, physical therapy or bracing or, in rare cases, surgery.

Without the help from Shriners Children's, I wouldn’t be doing what I’m doing now. I wouldn’t be living my dream.
Kerrigan, St. Louis
patient walking during motion analysis test

We'll Get Your Child Back in the Game

Shriners Children's is known around the world for treating some of the most rare pediatric orthopedic conditions. We also have nationally recognized sports medicine care. Our skilled, experienced physicians use the latest technology and proven treatments to help get young athletes back into competition. And we don't stop there. Our motion analysis team can take your child's athletic goals and customize a plan to help them stay healthy when they return to their sport.

Services We Provide

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Radiology and Imaging

Shriners Children's radiology and imaging services are a noninvasive way for physicians to see what's going on inside a child's body. Our radiology and imaging professionals work to do this in the safest way possible.

Athletic Training

Athletic training is provided by certified and licensed health care professionals, athletic trainers, who practice sports medicine.

Care Management

The care management team at Shriners Children's consists of registered nurses and social workers who act as resources for families throughout their plan of care.

Next Steps

Request an Appointment

Families and caregivers seeking treatment should start by contacting us for an appointment.

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Parents and guardians of existing patients can email, request records, schedule appointments and more.

Refer a Patient

Physicians and healthcare providers can request appointments, start transfers or contact us with questions.