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Spondylolysis: Causes, Diagnosis, and Treatment for Young People

Introduction to Spondylolysis: A Common Cause of Back Pain in Young People

What is Spondylolysis?

Spondylolysis is a cause of back pain in young people. It is known as a 'stress' fracture, and like many sports stress fractures, it usually heals to become symptom-free.

Who is Affected by Spondylolysis?

The diagnosis of a spondylolysis should be considered in back pain that occurs after strenuous sports on a consistent basis. Young gymnasts and young athletes involved in 'throwing' sports are most commonly affected. On the positive side, it seems more common in elite athletes.

Causes of Spondylolysis

It is a stress fracture that occurs at the 'pars interarticularis', which is a part of the back of the spinal bone, or the neural arch. It is not a serious structural fracture, and so normal activities can continue.

Diagnosis of Spondylolysis

Preferred Diagnostic Methods

In young people, radiation exposure with x-rays should be avoided when possible. The current investigation of choice is an MRI scan.

Prevalence and Specialist

Imaging It is present in between 3% and 6% of the population and often is found by chance and most commonly does not produce back pain. Specialist X-rays will sometimes be needed to be more sure of the diagnosis. A CT scan is sometimes requested by a specialist to assess healing or the need for surgical treatment. Specialist scans such as SPECT scans are sometimes useful in the assessment.

The Role of Surgery

Very few patients require surgery, as the stress fracture so often heals on its own.

Treatment of Spondylolysis

Activity Modifications and Rest

Avoidance of extension of the spine may help, and sometimes a period of rest from a specific sport will allow the fracture to heal. Sports can usually be returned to once the stress fracture has healed.

Importance of General Fitness

Maintaining general fitness with cross-training exercises while the stress fracture heals is important.

Healing Rates and Long-term Prognosis

It is said that 98% of the stress fractures will heal with time. Even if they do not heal, if they are not painful, no treatment is needed. A pain-free spondylolysis is not a weakness of the spine and should not prevent returning to impact sports, fitness, and normal activities.

EUROSPINE is a society of spine specialists of various disciplines with a large knowledge of spine pathologies. All well-known and accepted treatment modalities for spine pathologies are represented by the members of the society. However, the Society cannot accept any responsibility for the use of the information provided; the user and their health care professionals must retain responsibility for their health care management.

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