Spondylolysis (spon-duh-LOL-uh-sis or spon-duh-low-LIE-sis) is a fracture (crack
or break) in a vertebra (bone in the spine). It can happen from repetitive stress
or injuries to the spine. Some kids are born with spondylolysis.
Spondylolysis is a very common cause of lower back pain in kids, teens, and young
adults. It usually heals quickly with rest and physical therapy. Surgery usually isn't
How Does Spondylolysis Happen?
The spine (or backbone) has 33 bones called vertebrae (VER-tuh-bray). Nine vertebrae
are fused together to form the tailbone, and the other 24 are in the back. The lumbar
vertebrae are in the lower back (closest to the tailbone), and are where spondylolysis
Spondylolysis is a fracture in the part of the vertebra called the pars (or pars
interarticularis). Each vertebra has two pars, one on the left side and one on the
right. A pars defect or stress fracture can happen on one or both sides of this bone.
What Are the Signs of Spondylolysis?
Lower back pain is the most common symptom of spondylolysis. It usually gets worse
during exercise or other physical activity, especially activities where someone leans
back a lot. Spondylolysis also can cause buttock and leg pain, and tight hamstrings.
Sometimes, kids and teens with spondylolysis won't have any obvious symptoms and
don't realize that they have the condition.
Who Gets Spondylolysis?
Young people are more at risk for spondylolysis because their bones are still growing.
Kids and teens who play sports and do activities that can strain the lower back
or that involve a lot of leaning back — like football, weightlifting, gymnastics,
volleyball, ballet, golf, and wrestling — are especially likely to develop it.
How Is Spondylolysis Diagnosed?
Health care providers will do a thorough exam. During the exam, they might push
on the back or ask a patient to bend backward to hyperextend the spine. If these things
cause back pain, it's likely that there's a fracture in the pars.
Other things, such as muscle pain, a pinched nerve, or herniated (bulging) disc,
also can cause lower back pain. To rule those out — or to confirm a diagnosis
of spondylolysis — health care providers will order tests such as:
a back X-ray, which can show many fractures
a bone scan or a CT (computed tomography) scan, which can detect smaller fractures
The sports and activities that can cause spondylolysis often are very competitive
and attract motivated, driven kids and teens. So it's important to keep your child's
temperament in mind when dealing with spondylolysis and its recovery.
Besides their own wishes to return to what they love, kids and teens also might
be under pressure to get back into the game from coaches, teammates — and even
parents. But a safe return to play is very important. Kids should get the OK from
their health care provider before they return to physically demanding activities and
After spondylolysis, kids and teens need to keep up with the proper techniques
and sports safety
measures they learned in recovery. They should maintain their core strength and flexibility,
and take breaks between sports seasons, games, and competitions.
Also, be sure that your kids know to immediately stop an activity that causes back
pain. They should see their health care provider and not return to play until the
pain goes away.