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What Are Spondylolysis and Spondylolisthesis?

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


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