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Patient Education Article

Spondylolysis - Stress Fracture of the Spine

Back to Patient Education
  • Introduction
  • Anatomy
  • Causes
  • Symptoms
  • Diagnosis
  • Surgery
  • Treatment
  • Recovery

Introduction

Spondylolysis is a term to describe a stress fracture that occurs in the vertebrae of the lower spine.  Vertebrae are the series of bones that make up your spine.  Spondylolysis can result from excessive and repetitive forces during some sports.

Spondylolysis may not cause symptoms.  It can cause pain that spreads throughout the lower back.  Rest and back bracing can provide symptom relief.  Spinal fusion surgery may be necessary if non-surgical treatments are ineffective or if your condition gets worse.

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Anatomy

The lumbar area of your spine is located in your lower back.  It forms the curve below your waist.  Five large vertebrae make up the lumbar spine.  Ligaments and muscles connect to the spinal column and provide stability and movement.

The back part of each vertebra arches to form the lamina.  The lamina creates a roof-like cover over the back opening in each vertebra.  The opening in the center of each vertebra forms the spinal canal.  Your spinal cord and spinal nerves travel through the protective spinal canal.

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Causes

A stress fracture in a vertebra is called spondylolysis.  It may result from stress on the lower back during sports, such as gymnastics, weight lifting, and football.  Some individuals are born with thin vertebral bones that are susceptible to this condition.
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Symptoms

Spondylolysis may not cause symptoms.  It can cause lower back pain.  The pain may feel like a muscle strain that spreads across your lower back.
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Diagnosis

Your doctor can diagnose spondylolysis by reviewing your medical history and examining your back.  You should tell your doctor about sports that you participate in or job duties that may affect your back.  X-rays will be used to check for stress fractures and view your vertebral alignment.  CT scans or MRI scans often best indicate the fracture.
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Surgery

Surgery may be necessary if your symptoms do not improve or if your condition worsens.  Spondylolysis can lead to spondylolisthesis, a condition where the vertebrae slip out of place.  Spinal fusion surgery is used to permanently connect two or more vertebrae to stop movement and relieve pain.  A bone graft or surgical hardware, such as screws and rods, are used to secure the vertebrae together.  Spinal fusion surgery requires a short inpatient hospital stay followed by physical therapy.
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Treatment

Discontinuing the activities that may have caused the spondylolysis may relieve the pain associated with it.  Anti-inflammatory medications and pain medications and a back brace may help reduce pain.  Physical therapy may be recommended to strengthen and stretch your back and abdominal muscles.  You may be able to resume your activities gradually after your symptoms have subsided.
 
Physical and occupational therapy usually follows spinal fusion surgery.  Initially, your physical therapist will help you with bed mobility and sitting balance.  Your physical therapist will also focus on exercises to promote walking.  You may need to wear a back support or use an assistive device, such as a walker, until you are stronger.  Your physical therapy exercises will progress to strengthening your back and abdominal muscles. 
 
Your occupational therapist will teach you ways to perform simple daily tasks, such as dressing, bathing, and toileting, within the movement parameters that you have.  Your therapists can recommend and issue durable medical equipment, including shower chairs or dressing devices, to allow you to perform self-care tasks as independently as possible.
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Recovery

Recovery from spinal fusion surgery can take several months.  The length of your recovery depends on the extent of your condition and the type of surgery that you had.  Your doctor will let you know what to expect.
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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on February 16, 2022. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.

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At Suburban Physical Therapy in Brecksville and Twinsburg, OH, our highly skilled physical therapists provide treatment for a wide range of common injuries and conditions including Athletic & Sports Injuries, Return to Sport, Athletic Performance, Back and neck pain, Headaches and migraine headaches, Work-related injuries, Women’s Health, Alter-G™ Anti-Gravity Treadmill, Massage Therapy, Vestibular Therapy, Balance and fall prevention, Post-Operative Rehabilitation, and Nutritional Counseling.