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What is Spondylosis and Spondylolisthesis?

Young athletes often get lower back pain may be due to stress fracture in one of the spinal bone which can be seen on X-ray.  This condition is called the spondylosis and it usually affects the fifth lumbar vertebra in the lower back and, much less commonly, the fourth lumbar vertebra.

The stress fractures will sometimes deteriorate the bone such that it cannot retain its appropriate position causing the vertebra to shift out of place. This condition is known as spondylolisthesis.  If the vertebra is shifted out too much, the bones may press against the nerves. You should seek help for surgical treatment to correct the condition.


What are the Causes for Spondylosis and Spondylolisthesis?

Genetics

This cause of spondylosis and spondylolisthesis can be related to genetics. A new born may have thin vertebral bone since birth, and the chances for vertebral bone slipping out will increases during the rapid growth.

Overuse

Sports such as gymnastics, weight lifting and football place a huge amount of stress on the vertebra in the lower back. These athletes may also often overstretch their spine, as a result, causing a stress fracture on the vertebra.

  • Most people have spondylolysis and spondylolisthesis even though there are no clear symptoms.
  • Pain generally extends across the lower back and may feel like a muscle strain.
  • Spondylolisthesis can cause spasms that stiffen the back and tighten the hamstring muscles, causing changes to posture and gait. If the slippage is substantial, it may apply pressure on the nerves and narrow the spinal canal.

How is Spondylosis and Spondylolisthesis Diagnosed?

The doctor will take an X-ray of the patient’s lower back (lumbar) spine where the vertebra is located.

The pars interarticularis is part of the lumbar spine where it joins the upper and lower joints together.

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Left: The pars interarticularis is found in the posterior portion of the vertebra. 

Center: Spondylolysis occurs when there is a fracture of the pars portion of the vertebra.

Right: Spondylolisthesis occurs when the vertebra shifts forward due to instability from the pars defect.

When there is a fracture on the pars, the condition is known as spondylolysis and an X-ray will be able to show the skeletal defects.

Spondylolisthesis condition occurs when the fracture gap at the pars become wider and the vertebra moves forward. Typically the fifth lumbar vertebra moves forward on the part of the pelvic bone called the sacrum. The standing lateral spine X-rays determines the amount of forward slippage.

A CT scan or MRI may be needed to examine any changes or deformity prior to treatment


What are the Treatments for Spondylosis and Spondylolisthesis?

Nonsurgical Treatment

The early treatment for spondylosis is usually non-surgical. Patient is encouraged to stop any strenuous activity until the pain ease or recover. Some anti-inflammatory medications such as ibuprofen may ease or lessen the back pain. 

X-ray can be taken regularly to check if the vertebra is changing position

Surgical Treatment

If non-surgical treatment does not ease the pain or the slippage gradually become worse and it interfere with daily living activities, surgical treatment may be required. The procedures will be done between the lumbar vertebra and the sacrum. Internal braces or screws and rods may be used to hold the vertebra together.