Spondylolyse

Spondylolysis is a defect or stress fracture in the pars interarticularis of the vertebral arch. The vast majority of cases occur in the lower lumbar vertebrae (L5), but spondylolysis may also occur in the cervical vertebrae. In majority of cases, spondylolysis presents asymptomatically, which can make diagnosis both difficult and incidental. When a patient does present with symptoms, there are general signs and symptoms a clinician will look for: Clinical signs: Pain on completion of the stork test (placed in hyperextension and rotation) Excessive lordotic posture Unilateral tenderness on palpation Visible on diagnostic imaging (Scottie dog fracture) Symptoms: Unilateral low back pain Pain that radiates into the buttocks or legs Onset of pain can be acute or gradual Pain that can restrict daily activities Pain that worsens after strenuous activity Pain aggravated with lumbar hyperextension Difficulty in movement in spinal cord The cause of spondylolysis remains unknown, however many factors are thought to contribute to its development. The condition is present in up to 6% of the population, the majority of which usually present asymptomatically. Research supports that there are hereditary and acquired risk factors that can make one more susceptible to the defect. The disorder is generally more prevalent in males than in females and tends to occur earlier in males due to their involvement in more strenuous activities at a younger age. In a young athlete, the spine is still growing; there are many ossification centers, leaving points of weakness in the spine. This leaves young athletes at increased risk, particularly when involved in repetitive hyperextension and rotation across the lumbar spine. Spondylolysis is a common cause of low back pain in preadolescents and adolescent athletes, as it accounts for about 50% of all low back pain. It is believed that both repetitive trauma and an inherent genetic weakness can make an individual more susceptible to spondylolysis.