Spondylolysis, also known as a Pars Defect, occurs when a small, thin portion of bone that connects two vertebrae (known as the Pars) cracks or fractures. This can weaken the bones of the spine and lead to the spine not being supported. When this occurs, it can cause one vertebra to slip down over another.
Spondylolysis Treatment Options
Spondylolysis treatment is focused on managing any pain and promoting healing. The goal gets patients back to their daily routine as soon as possible. Thankfully, spondylolysis doesn’t normally cause spinal cord injury or nerve damage.
Depending on the degree of pain and the fracture, treatment usually begins with:
- Taking a break from any sports
- Drugs like NSAIDs
- Heat/cold therapy
- Physical therapy to strengthen core muscles
In cases where the pars is badly damaged, doctors may suggest surgery. The surgery will repair and stabilize the pars and prevent any further injury.
Non-surgical Spondylolysis Treatment
Most patients respond well to non-surgical treatment, and at Southwest Scoliosis Institute, Doctors Hostin, Kishan, and Wiesman always try to exhaust all avenues of non surgical treatment before considering surgery.
This usually starts with medicine to reduce pain. The doctors use over-the-counter drugs like NSAIDs, and patients are also advised to take a break from sports.
Non surgical treatment usually involves strengthening the core muscles to minimize the chances of hurting the spine. For instance, this may include specific exercises and physical therapy. Hot and cold therapy, ultrasound, electrical stimulation, and other therapies may also reduce the pain and muscle spasms that often occur with spondylolysis.
If necessary, our doctors will administer spinal injections (blocks) to relieve some of the pain. This involves injecting a steroid into the area around the spinal nerves (epidural) or between vertebrae (facet joints). Patients may require just a single injection or several over time to help reduce pain.
Surgery for Spondylolysis Treatment
Spondylolysis rarely requires surgery. However, if the pain, spasms, or slippage do not get better or increase after a period of non surgical treatment, your doctor may discuss potential surgical options. The goal of spondylolysis surgery is usually to stabilize the spine and prevent or repair any slippage of vertebrae, as well as to prevent the condition from progressing any further.
Spinal fusion. Fusion surgery restores stability to the spine and prevents the vertebrae from putting pressure on or doing damage to the spinal cord and nearby nerves. A fusion procedure involves removing any loose bone fragments and using a bone graft and specially designed screws and rods to fuse the two vertebrae. In some cases, the bones may need realignment depending on the severity of the slippage.
Pars repair. In some cases, doctors can repair a pars fracture without needing to fuse the vertebrae together. The surgeon carefully removes any scar tissue that may have developed at the fractured vertebrae and stabilizes the two sides of the fracture to restore normal anatomy.
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Who gets Spondylolysis?
Spondylolysis usually affects children and adults younger than 26 years old, and it’s more common in those who play sports that put a lot of stress on the lower back or cause them to hyperextend their back. This includes things like gymnastics, weightlifting, and even football, and the condition occurs more often in boys than in girls.
What are the Symptoms?
Many people who develop spondylolysis only show minor symptoms. Some never have any symptoms, but the condition will become visible in an X-ray for an unrelated condition or injury. Because it occurs most often in the lumbar spine, low back pain is the most common symptom.
The symptoms often vary from patient to patient, but generally include:
- Persistent lower back pain
- Pain that radiates to the buttocks and back of the thighs
- Stiffness in the back or leg muscles
- Hamstring muscle tightness
Low back pain due to spondylolysis often spreads across the lower back and might feel like a muscle strain. It often gets worse when the person engages in lots of exercise or activity and gets better with rest.
How is it Diagnosed
In order to diagnose spondylolysis, the doctors at Southwest Scoliosis Institute begin by carefully reviewing your medical history, after which they will perform a thorough physical exam.
The doctor may perform a one-legged test, which requires patients to stand on one leg and lean back. If this causes pain on the standing leg, it indicates spondylolysis on that side. Patients may test positive on one side, both, or neither.
If spondylolysis is suspected, your doctor may order X-ray imaging of your back using our state-of-the-art EOS X-ray imaging system. This is useful when treating children because this system uses a very low dose of radiation in order to take images of the bones.
It also takes images in multiple positions, so patients can stand or sit depending on what is more comfortable for them without the need to lie down during the exam. However, cracks and/or slippage are sometimes difficult to spot on an X-ray image, so more tests can assist in making a definitive diagnosis.
CT scans can show a crack or defect in the bone more clearly, and a magnetic resonance imaging (MRI) scan can view the soft tissue structures of the spine (including the discs between the vertebrae, as well as any affected nerves) and their relationship to the fracture – as well as whether any slippage occurred.
If you or your loved one is suffering from scoliosis, spondylolysis, or another complex spine condition, there is hope. We can help. Call Southwest Scoliosis Institute at 214-556-0555 to make an appointment today.