What Are Spondylolysis and
Spondylolisthesis?
By Laurence Schubert APAM
The spine is arguably the most important
structure in the human body. As humans, we are endoskeletons, meaning our bones
are found on the inside of our body. Often referred to as the spinal column,
the spine is strong supporting structure that provides the entire framework for
our body. Whilst the spine is robust, it has an important function of allowing
movement. Like the entire human body, the spine is susceptible to injury. You
may have heard of the terms Spondylolysis and Spondylolisthesis.
What Are Spondylolysis and
Spondylolisthesis?
Spondylolysis refers to a fracture in part of the vertebra that extends posteriorly
and forms the bone that you can see when people bend forward. In more
scientific terms, a fracture to the pars interarticularis. When this fracture becomes
complete, and entirely separates it is known as Spondylolisthesis.
Spondylolisthesis is the complete fracture of part of the spine, occurring in progression
of a Spondylolysis. Once the fracture is separated it is given grades to
classify its severity. Generally, these two conditions affect the lower lumbar (low
back) vertebrae, typically at L4 and L5.
What are the causes?
Spondylolysis and spondylolisthesis occur
either due to an acute injury or a degenerative process over time. This injury
commonly occurs in young people as a result of trauma typically when the spine
is forced into extension at high loads. Sports that have repetitive extension
movements such as gymnastics, football and weightlifting are also at risk of
this injury, as over time it can lead to stress fracture.
In older adults, spondylolysis or
spondylolisthesis will likely be caused by generative changes. Due to natural
ageing processes, osteoporosis, infection or tumour can cause this injury.
Genetics also play in role in these conditions as some people are more susceptible
than others.
What are the symptoms?
Often the symptoms of Spondylolysis and
spondylolisthesis are very subtle, and it is likely that you will not even
notice them. As the symptoms progress, you will begin to experience pain and
tightness across the low back. This condition is easy misdiagnosed as muscular
strain as pain often presents similarly across the low back. It is likely that
bending forward will help relieve your symptoms and aggravated by walking,
running (especially uphills) or anything that causes spinal extension.
If the conditions become more progressive, there
can be a slipping forward/backward of the vertebral body (bone in between your
discs). This causes a narrowing of the spinal canal and compresses the spinal
cord, thus causing neural symptoms. This includes pain and tightness down your
hamstring/thigh, numbness and tingling, weakness and unco-ordinated lower limb
movements.
How can your physiotherapist help?
Your physiotherapist will first ensure a
correct diagnosis. Spinal issues are made complex if poor diagnosis takes
place. Then your physio will work with you in determining whether any other
health professionals are needed for the management of your case. In severe
cases, stabilisation surgery may be required. However, this in rare and in most
cases Spondylolysis and spondylolisthesis can be managed conservatively (no
surgery).
Physiotherapy will likely focus on altering/modifying your current physical activity. It is important that we help you find ways for you to continue doing the things you love, whether this be sports/gym or activities at home such as gardening. Strength training is often a significant aspect of rehab, as well as improving mobility in the spine and other areas that require attention.
If you have any questions about back pain or these two conditions then please contact us or book online for an appointment
