Spondylolysis is a stress fracture. It occurs in a part of the vertebrae (spinal bone). The pars interarticularis is a portion of the bone between the facets. There is a right and left section.
This condition occurs in the lower back. About 90% of the time, it is in the fifth lumbar vertebra. It can fracture on one or both sides (bilateral). Left untreated, it can lead to spondylolisthesis. This is a more serious condition. The vertebra slips forward on the one below it. Both conditions can cause back pain.
This fracture is the most common cause of back pain in adolescent athletes.
Spondylolysis can be caused by:
Factors that may increase the chance of spondylolysis include:
Many people have no symptoms at all. In those that have them, symptoms may include:
You will be asked about your symptoms and medical history. A physical exam will be done.
Imaging tests to find the fracture and look for other problems in the soft tissue may include:
If you have symptoms, treatment may include:
Do not do athletic activities for several weeks to several months. In general, this restriction should last until the symptoms are gone.
The doctor may suggestwearing a back brace. This will help relieve pain. About 4-6 weeks of bracing may be needed. The brace should limit extension of the lower (lumbar) spine.
To relieve the pain and prevent recurrences, a physical therapist can teach:
Surgery may be needed if there is:
Two procedures are usually needed:
To help reduce your chance of spondylolysis:
Healthy Children—American Academy of Pediatrics
Ortho Info—American Academy of Orthopaedic Surgeons
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
Boden BP, Osbahr DC, et al. Low-risk stress fractures. Am J Sports Med. 2001;29(1):100-111.
Bono CM. Low-back pain in athletes. J Bone Joint Surg Am. 2004;86-A(2):382-396.
Eddy D, Congeni J, et al. A review of spine injuries and return to play. Clin J Sport Med. 2005;15(6):453-458.
Herman MJ, Pizzutillo PD. Spondylolysis and spondylolisthesis in the child and adolescent: A new classification. Clin Orthop Relat Res. 2005;(434):46-54.
Lumbar spondylolysis. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116565/Lumbar-spondylolysis. Updated July 16, 2015. Accessed November 27, 2017.
Nitta A, Sakai T, Goda Y, et al. Prevalence of Symptomatic Lumbar Spondylolysis in Pediatric Patients. Orthopedics. 2016;39(3):e434-e437.
Peer KS, Fascione JM. Spondylolysis: a review and treatment approach. Orthop Nurs. 2007;26(2):104-111.
A report from the Scoliosis Research Society Evidence-Based Medicine Committee. Spine Deformity. 2017;5:97-101.
Sakai T, Yamada H, et al. Lumbar spinal disorders in patients with athetoid cerebral palsy: a clinical and biomechanical study. Spine. 2006;31(3):E66-E70.
Last reviewed November 2017 by EBSCO Medical Review Board Laura Lei-Rivera, PT, DPT, GCS
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.