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Spondylolysis, sometimes called a pars fracture, 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?
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.
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.
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- Physical Therapy
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- Reconstructive Surgery