Spondylolysis
Spondylolysis is a stress fracture or crack in a vertebrae . It often occurs in the lower spine at the L5 vertebrae.
What’s in this section?
Signs and symptoms
Symptoms of spodylolysis depend on the severity of the fracture and commonly include:
- Lower back pain
- Made worse with movement
- Made better with rest
- Radiating pain into the buttocks and hamstrings
Potential causes
Spondylolysis is often the result of overuse and overstretching of the lower back. Sports such as gymnastics, football and weightlifting can cause this injury. Individuals can also be born with thinner vertebrae, which are more vulnerable to injury.
Diagnosis
Diagnosis of spondylolysis starts with a physical exam and medical history. Other procedures and tests may be needed to diagnose, including x-rays , computed tomography (CT) and magnetic resonance imaging (MRI).
Treatment options
There are different treatment options depending on the severity of your symptoms:
- Rest to reduce the lower back stressors.
- Medication to control pain and inflammation.
- Physical therapy to strengthen the surrounding muscles.
- Disc decompression and fusion. This procedure is performed to take pressure off of the nerves in the lower back and to treat or prevent instability of the lower spine. Patients who are good candidates for surgery usually have back and leg symptoms: pain, weakness, changes in sensation and trouble standing up straight or walking distances. The surgery is performed through an incision, and your surgeon will remove a window of bone, called a laminectomy, as well as ligament and parts of the joints of the spine to take the pressure off of the nerves. The fusion portion of the procedure involves using screws and rods to connect bones of the spine together, along with placing bone graft material which will grow over time, typically 6 – 12 months, and fuse the bones of the spine together.
- Artificial disc replacement. Artificial discs are an alternative to fusion. The goal of surgery remains the same: to get the pressure off the nerves or spinal cord to relieve the symptoms. The difference is that once this goal has been achieved, an artificial disc maintains motion at that level, whereas a fusion stops all motion at the surgical level. An incision is made and the tissue planes are separated until the surgeon gets down to the front of the spine. The disc is then removed slowly in small pieces and the pressure is pulled away from the spinal cord and/or nerve roots. An artificial disc, which can be made from many different materials depending on the manufacturer, is put into the space where the disc once was. This artificial disc has to be precisely placed so that it provides similar motion to the original disc.
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