Spondylolysis:

Spondylolysis is a defect in the pars interarticularis of the vertebra. Spondylolisthesis is the translation or slippage that occurs through this defect. About 5% of the general population have a spondylotic defect or a spondylolisthesis in the lumbar spine. This is the most common type of spondylolisthesis. Spondylolisthesis can also occur as a result of degenerative changes, trauma, tumor, congenital changes or postoperative instability.

The treatment for pain due to spondylolisthesis is activity modification, anti-inflammatory drugs and pain medications when needed. If the pain is intractable or associated with a neurologic deficit, the most common one would be L5 or S1. Problems such as weakness of the calf muscles when tiptoeing or the dorsiflexors of the ankle when walking on the heels or pain and numbness in the big toe (L5) or little toe (S1) may occur.

Physical therapy, isometric exercises to strengthen the trunk, and avoidance of activities that require extremes of motion of the back are recommended. We discourage hyperextension as associated with diving, gymnastics, football lineman maneuvers.

If surgery becomes necessary, the indications would be obvious progression of the slip, intractable pain or neurologic deficit. Reduction is possible. Spondylolysis is a defect in the pars interarticularis of the vertebra. Spondylolisthesis is the translation or slippage that occurs through this defect. About 5% of the general population have a spondylotic defect or a spondylolisthesis in the lumbar spine. This is the most common type of spondylolisthesis. Spondylolisthesis can also occur as a result of degenerative changes, trauma, tumor, congenital changes or postoperative instability.

The treatment for pain due to spondylolisthesis is activity modification, anti-inflammatory drugs and pain medications when needed. If the pain is intractable or associated with a neurologic deficit, the most common one would be L5 or S1. Problems such as weakness of the calf muscles when tiptoeing or the dorsiflexors of the ankle when walking on the heels or pain and numbness in the big toe (L5) or little toe (S1) may occur.

Physical therapy, isometric exercises to strengthen the trunk, and avoidance of activities that require extremes of motion of the back are recommended. We discourage hyperextension as associated with diving, gymnastics, football lineman maneuvers.

If surgery becomes necessary, the indications would be obvious progression of the slip, intractable pain or neurologic deficit. Reduction is possible. The surgery involves a fusion of the spondylotic elements.

Hospitalization is usually three to five days. Patients return to sedentary activities in the workplace within a month. Most patients get as good as they are going to get within four to six months of the surgery. The recovery depends on the preoperative aerobic conditioning of the patient.