Spondylolysis

Spondylolysis is a stress fracture that occurs in the posterior aspect of the spine. It can occur in around 5% of individuals but is more common in sports people. It can result in localised back pain with occasional referral into the legs if there is some nerve irritation. Sometimes bilateral stress fractures can occur which can lead onto a spondylolisthesis.
After history and physical examination, a neurological assessment may be required with subsequent standing x-rays and either an MRI and/or a CT scan suggested to look more closely at the fracture. These tests may confirm if the fracture is new or old.
Initial treatment would be a period of rest and rehabilitation. Occasionally a brace is used to prevent extension, and this would be worn for anywhere between six to twelve weeks. After removal of the brace then physical therapy is required. Occasionally injections into the stress fracture can be used to help in rehabilitation.
Surgical intervention is very rarely required as 95% of individuals improve with conservative management.