Spondylolysis & Spondylolisthesis in Children

Spondylolysis is a defect in the spine at a location of the bone known as the pars interarticularis.  The term spondylolysis comes from the greek word "spondylos" which means spine, and "lysis" which means split.  This pars region represents the connection between the front part of the back bone (vertebral body) which houses the spinal cord and nerves, to the back part of the back bone (posterior elements).  It is not uncommon to find as many as six percent of ambulatory children with spondylolysis.  

Spondylolisthesis is commonly assciated with spondylolysis.  While "lysis" is a greek term for split, "listhesis" is a term that describes forward slippage.  Thus, spondylolisthesis typically occurs when someone has a spondylolysis and then as a result, one bone slips forward in relation to another.

These two conditions are the most common causes of chronic back pain in children.

Causes & Symptoms

Spondylolysis is caused either by genetics, overuse or repetitive injuries or both. Children at highest risk to develop these defects are those that participate in sports that require repetitive arching of the back, such as gymnastics, cheerleading, weightlifting, and football. 

Many children are symptom free and the condition is often overlooked.  However, when spondylolysis has symptoms, it is typically lower back pain, intensified when arching the back. In rare cases, youe child could feel pain that goes down the legs.  The pain is typically severe enough that your child may not want to participate in their sport. 

Diagnosis

At your appointment, your COA provider will be looking for signs of stress fractures. Our team will look at the following:

  • Complete history and physical
  • X-ray of the lower back

Sometimes a CT scan or a MRI might be used to look for very small fractures, rule out other possible causes of pain and plan treatment options.

Treatment

A conservative treatment is often sufficient in treating spondylolysis. Getting plenty of rest, the proper medication and appropriate physical therapy, with the intention of reducing pain and swelling, usually allows the fracture to heal. In some cases, a back brace worn for a short period of time might be necessary to take the pressure off the lower back.

In the rare event that your childs' pain continues despite all these efforts, it may be necessary to repair the defect surgically. There are two types of repair recommended at COA:

  • Fracture Repair – In this procedure, the goal is to repair the bone by bridging a metal implant and a bone graft across the fracture.
  • Lumbar Fusion - In this procedure, the goal is to actually fuse the bone together using screws and a bar to stabilize the spine. A bone graft is also used to help the bones grow back together.

Learn More

If your child has been diagnosed with spondylolysis or if they are experiencing back pain, schedule an appointment with us today.

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