Spondylolysis

Spondylolysis (spon-dee-low-lye-sis) is defined as a defect or stress fracture in the pars interarticularis of the vertebral arch. The vast majority of cases occur in the lower lumbar vertebrae (L5), but spondylolysis may also occur in the cervical vertebrae.

In majority of cases, spondylolysis presents asymptomatically which can make diagnosis both difficult and incidental. When a patient does present with symptoms, there are general signs and symptoms a clinician will look for:

Clinical Signs:

• Pain on completion of the stork test (placed in hyperextension and rotation)
• Excessive lordotic posture
• Unilateral tenderness on palpation
• Visible on diagnostic imaging (Scottie dog fracture)

Symptoms:

• Unilateral low back pain
• Pain that radiates into the buttocks or legs
• Onset of pain can be acute or gradual
• Pain that can restrict daily activities
• Pain that worsens after strenuous activity
• Pain aggravated with lumbar hyperextension
• Difficulty in movement in spinalcord