Skip to main content

Spondylolysis

  • Chapter
  • First Online:
Tennis Medicine

Abstract

Spondylolysis is a bone defect that affects the pars interarticularis of a vertebra (Fig. 30.1). The pars interarticularis is a small isthmus located between the facet joints of the vertebrae above and below. This usually occurs on a bilateral basis, affecting the L5 (85–95%) and on rarer occasions affecting the proximal lumbar vertebrae, the affectation of which is usually unilateral. An isthmic unilateral lesion is observed in 14–30% of cases. It may be associated with injuries at other levels or with lysis on the contralateral side, which develops over time. Although it is rare, it may affect several levels simultaneously.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Amato ME, Totty WG, Gilula LA. Spondylolysis of the lumbar spine: demonstration of defects and laminal fragmentation. Radiology. 1984;153:627–9.

    Article  CAS  Google Scholar 

  2. Danielson BI, Frennered AK, Irstam LK. Radiologic progression of isthmic lumbar spondylolisthesis in young patients. Spine. 1991;16:422–5.

    Article  CAS  Google Scholar 

  3. Lee J, Ehara S, Tamakawa Y, et al. Spondylolysis of the upper lumbar spine: radiological features. Clin Imaging. 1999;23:389–93.

    Article  CAS  Google Scholar 

  4. Roche MB, Rowe GG. The incidence of separate neural arch and coincident bone variations. J Bone Joint Surg. 1952;34:491–4.

    Article  Google Scholar 

  5. Rossi F. Spondylolysis, spondylolisthesis and sports. J Sport Med Phys Fit. 1978;18:317–40.

    CAS  Google Scholar 

  6. Rossi F, Dragoni S. Lumbar spondylolysis: occurrence in competitive athletes. Updated achievements in a series of 390 cases. J Sport Med Phys Fit. 1990;30:450–3.

    CAS  Google Scholar 

  7. Sairyo K, Katoh S, Sasa T, et al. Athletes with unilateral spondylolysis are at risk of stress fracture at the contralateral pedicle and pars interarticularis. A clinical and biomechanical study. Am J Sports Med. 2005;33(4):583–90.

    Article  Google Scholar 

  8. Randall R, Silverstein M, Goodwin R. Review of pediatric spondylolysis and spondylolisthesis. Sports Med Arthrosc Rev. 2016;24:184–7.

    Article  Google Scholar 

  9. Fredrickson BE, Baker D, McHollick WJ, Yuan HA, Lubicky JP. The natural history of spondylolysis and spondylolisthesis. J Bone Joint Surg. 1984;66:699–707.

    Article  CAS  Google Scholar 

  10. Morita T, Ikata T, Katoh S, Miyake R. Lumbar spondylolysis in children and adolescents. J Bone Joint Surg. 1995;77B:620–5.

    Article  Google Scholar 

  11. Nozawa S, Shimizu K, Miyamoto K, et al. Repair of pars interarticularis defect by segmental wire fixation in young athletes with spondylolysis. Am J Sports Med. 2003;31(3):359–64.

    Article  Google Scholar 

  12. Lawrence JP, Greene HS, Grauer JN. Back pain in athletes. J Am Acad Orthop Surg. 2006;14:726–35.

    Article  Google Scholar 

  13. Jones GT, Macfarlane GJ. Epidemiology of low back pain in children and adolescents. Arch Dis Child. 2005;90:312–6.

    Article  CAS  Google Scholar 

  14. Simper LB. Spondylolysis in eskimo skeletons. Acta Orthop Scand. 1986;57:78–80.

    Article  CAS  Google Scholar 

  15. Cassidy RC, Shaffer WO, Johnson DL. Spondylolysis and spondylolisthesis in the athlete. Sports Med Update. 2005;28(11):1331.

    Google Scholar 

  16. Standaert CJ, Herring SA. Expert opinion and controversies in sports and musculoskeletal medicine: the diagnosis and treatment of spondylolysis in adolescent athletes. Arch Phys Med Rehabil. 2007;88(4):537–40.

    Article  Google Scholar 

  17. Micheli LJ, Wood R. Back pain in young athletes: significant differences from adults in causes and patterns. Arch Pediatr Adolesc Med. 1995;149:15–8.

    Article  CAS  Google Scholar 

  18. Hensinger RN. Spondylolysis and spondylolisthesis in children. Instr Course Lect. 1983;32:132–51.

    CAS  PubMed  Google Scholar 

  19. Ruiz-Cotorro A, Balius Matas R, Estruch Massana A, Vilaro Angulo J. Spondylolysis in young tennis players. Br J Sports Med. 2006;40:441–6.

    Article  CAS  Google Scholar 

  20. McCleary MD, Congeni JA. Current concepts in the diagnosis and treatment of spondylolysis in young athletes. Curr Sports Med Rep. 2007;6(1):62–6.

    PubMed  Google Scholar 

  21. Wynne-Davies R, Scots JHS. Inheritance and spondylolisthesis. J Bone Joint Surg Am. 1979;61:301–5.

    Article  Google Scholar 

  22. Albanese M, Pizzutillo P. Family study of spondylolysis and spondylolisthesis. J Pediatr Orthop. 1982;2:464–99.

    Article  Google Scholar 

  23. Bennett DL, Nassar L, DeLano MC. Lumbar spine MRI in the elite-level female gymnast with low back pain. Skelet Radiol. 2006;35:503–9.

    Article  Google Scholar 

  24. Sagi HC, Jarvis JG, Uhthoff HK. Histomorphic analysis of the development of the pars interarticularis and its association with isthmic spondylolysis. Spine. 1998;23:1635–40.

    Article  CAS  Google Scholar 

  25. Miller SF, Congeni J, Swanson K. Long-term functional and anatomical follow up of early detected spondylolysis in young athletes. Am J Sports Med. 2004;32:928–33.

    Article  Google Scholar 

  26. Kim HJ, Green DW. Spondylolysis in the adolescent athlete. Curr Opin Pediatr. 2011;23:68–72.

    Article  Google Scholar 

  27. Nyska M, Constantini N, Cale-Benzoor M, Back Z, Kahn G, Mann G. Spondylolysis as a cause of low back pain in swimmers. Int J Sports Med. 2000;21:375–9.

    Article  CAS  Google Scholar 

  28. Soler T, Calderon C. The prevalence of spondylolysis in the Spanish elite athlete. Am J Sports Med. 2000;28:57–62.

    Article  CAS  Google Scholar 

  29. Sakai T, Sairyo K, Suzue N, Kosaka H, Yasui N. Incidence and etiology of lumbar spondylolysis: review of the literature. J Orthop Sci. 2010;15(3):281–8.

    Article  Google Scholar 

  30. Wiltse LL, Newman PH, MacNab J. Classification of spondylolysis and spondylolisthesis. Clin Orthop Relat Res. 1976;117:23–9.

    Google Scholar 

  31. Hasler C, Dick W. Spondylolysis and spondylolisthesis during growth. Orthopade. 2002;31:78–87.

    Article  CAS  Google Scholar 

  32. Logroscino G, Mazza O, Aulisa G, Pitta L, Pola E, Aulisa L. Spondylolysis and spondylolisthesis in the pediatric and adolescent population. Childs Nerv Syst. 2001;17(11):644–55.

    Article  CAS  Google Scholar 

  33. Bhatia NN, Chow G, Timon SJ, Watts HG. Diagnostic modalities for the evaluation of pediatric back pain: a prospective study. J Pediatr Orthop. 2008;28:230–3.

    Article  Google Scholar 

  34. Tallarico RA, Madom IA, Palumbo MA. Spondylolysis and spondylolisthesis in the athlete. Sports Med Arthrosc. 2008;16:32–8.

    Article  Google Scholar 

  35. Masci L, Pike J, Malara F, Phillips B, Bennell K, Brukner P. Use of the one-legged hyperextension test and magnetic resonance imaging in the diagnosis of active spondylolysis. Br J Sports Med. 2006;40(11):940–6.

    Article  CAS  Google Scholar 

  36. Hu SS, Tribus CB, Diab M, Ghanayem AJ. Spondylolisthesis and spondylolysis. J Bone Joint Surg Am. 2008;90:656–71.

    PubMed  Google Scholar 

  37. Salminen JJ, Erkintalo MO, Pentti J, Oksanen A. Recurrent low back pain and early disc degeneration in the young. Spine. 1999;24:1316–21.

    Article  CAS  Google Scholar 

  38. Ward CV, Latimer B, Alander DH, et al. Radiographic assessment of lumbar facet distance spacing and spondylolysis. Spine. 2007;32:E85–8.

    Article  Google Scholar 

  39. Libson E, Bloom RA, Dinari G, Robin G. Oblique lumbar spine radiographs importance in young patients. Spine. 1984;151:89–90.

    CAS  Google Scholar 

  40. Friberg O. Lumbar instability: a dynamic approach by traction-compression radiography. Spine. 1987;12:119–29.

    Article  CAS  Google Scholar 

  41. Beck NA, Miller R, Baldwin K, et al. Do oblique views add value in the diagnosis of spondylolysis in adolescents? J Bone Joint Surg Am. 2013;95:e65.

    Article  Google Scholar 

  42. Van der Wall H, Storey G, Magnussen J, et al. Distinguishing scintigraphic features of spondylolysis. J Pediatr Orthop. 2002;22:308–11.

    PubMed  Google Scholar 

  43. Takemitsu M, El Rassi G, Woratanarat P, Shah SA. Low back pain in pediatric athletes with unilateral tracer uptake at the pars interarticularis on single photon emission computed tomography. Spine. 2006;31:909–14.

    Article  Google Scholar 

  44. Gregory PL, Batt ME. SPECT and rg-CT findings in patients with back pain investigated for spondylolysis. Clin J Sport Med. 2005;15(2):79–86.

    Article  Google Scholar 

  45. Trout AT, Sharp SE, Anton CG, et al. Spondylolysis and beyond: value of SPECT/CT in evaluation of low back pain in children and young adults. Radiographics. 2015;35:819–34.

    Article  Google Scholar 

  46. Campbell RS, Grainger AJ, Hide IG, Papastefanou S, Greenough CG. Juvenile spondylolysis: a comparative analysis of CT, SPECT and MRI. Skelet Radiol. 2005;34(2):63–73.

    Article  CAS  Google Scholar 

  47. Rush JK, Astur N, Scott S, et al. Use of magnetic resonance imaging in the evaluation of spondylolysis. J Pediatr Orthop. 2015;35:271–5.

    PubMed  Google Scholar 

  48. Major NM, Helms CA, Richardson WJ. MR imaging of fibrocartilaginous masses arising on the margins of spondylolysis defects. AJR. 1999;173:673–6.

    Article  CAS  Google Scholar 

  49. Muschik M, Hahnel H, Robinson PN, et al. Competitive sports and the progression of spondylolisthesis. J Pediatr Orthop. 1996;16:364–9.

    Article  CAS  Google Scholar 

  50. Urrutia J, Cuellar J, Zamora T. Spondylolysis and spina bifida occulta in pediatric patients: prevalence study using computed tomography as a screening method. Eur Spine J. 2016;25:590–5.

    Article  Google Scholar 

  51. Hammerberg KW. New concepts on the pathogenesis and classification of spondylolisthesis. Spine (Phila Pa 1976). 2005;30(Suppl):S4–11.

    Article  Google Scholar 

  52. Li Y, Hresko MT. Radiographic analysis of spondylolisthesis and sagittal spinopelvic deformity. J Am Acad Orthop Surg. 2012;20:194–205.

    Article  Google Scholar 

  53. Wood KB, Popp CA, Transfeldt EE, Geissele AE. Radiographic evaluation of instability in spondylolisthesis. Spine. 1994;19:1697–703.

    Article  CAS  Google Scholar 

  54. Sairyo K, Sakai T, Yasui N. Conservative treatment of lumbar spondylolysis in childhood and adolescence: the radiological signs which predict healing. J Bone Joint Surg Br. 2009;91(2):206–9.

    Article  CAS  Google Scholar 

  55. Balius Matas R. Espondilólisis y espondilolistesis en el deporte. Factores pronóstico y estudio longitudinal (Spondylolysis and spondylolisthesis in sports. Prognosis factors and longitudinal study). Doctoral thesis. Universitat Autònoma de Barcleona, Barcelona, 1996.

    Google Scholar 

  56. Lundine KM, Lewis SJ, Al-Aubaidi Z, et al. Patient outcomes in the operative and nonoperative management of high-grade spondylolisthesis in children. J Pediatr Orthop. 2014;34:483–9.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Pedret, C., Balius, R., Ruiz-Cotorro, A. (2018). Spondylolysis. In: Di Giacomo, G., Ellenbecker, T., Kibler, W. (eds) Tennis Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-71498-1_30

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-71498-1_30

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-71497-4

  • Online ISBN: 978-3-319-71498-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics