Spondylolysis

What is spondylolysis?

Spondylolysis is a spinal disorder that affects the vertebrae (not the vertebral disc). It involves a joint injury caused by a fissure or fracture (hence the term "lysis") that in itself causes pain. However, when present in an environment with healthy muscles and joint tissues such as ligaments and cartilage, it can simply manifest as lower back pain. In more severe cases, it can cause neurological involvement, producing symptoms similar to those of lumbosciatica.

How does spondylolysis occur?

Casi siempre se producen por movimientos que exceden los rangos de movimiento habituales, o por presentar traumatismos directos o indirectos en la espalda. Las articulaciones se encuentran por la parte de atrás de las vértebras (cara posterior) y son las que permiten mantener a las vértebras en su sitio correcto como lo haría, en un comparativo cotidiano, una bisagra en una puerta con el marco. Del mismo modo, la lesión se clasifica en grados de severidad, si es en una sola vértebra, de un solo lado derecho o izquierdo, o si involucra más segmentos vertebrales, aumentando en estos casos, la posibilidad de que el segmento se vuelva inestable y por consiguiente, produzca un desplazamiento, como lo haría una fractura en cualquier otra parte de nuestro esqueleto

Symptoms and diagnosis of spondylolysis

Symptoms can vary, but are usually acute, localized pain caused by trauma or forced movement, although it can also be due to a genetic defect.

If the fracture is very severe, it can cause neurological impairment and displacement, leading to a diagnosis of SPONDYLOLISTESIS.

It is true that joints are small and difficult to diagnose, although under the evaluation of an experienced radiologist or traumatologist, it can be suspected and diagnosed with X-rays.

The diagnostic test of choice is considered to be the CT scan, due to its great ability to identify bone tissue, but the Magnetic Resonance Imaging is not far from the first site, since it allows us to confirm if there is affectation of the rest of the joint, allowing us to very correctly assess the neurological, disc and muscular tissue.

What is the treatment for spondylolysis?

Initially, conservative treatment is helpful, especially if combined with a lumbar support belt with posterior reinforcement (in the case of the lumbar region) and a collar (in the case of the cervical region), ensuring stability of the segment and ensuring there is no associated neurological injury. Treatment is provided with anti-inflammatory drugs, muscle relaxants, and rest.

Cuando el tratamiento inicial no ha sido óptimo, o el segmento presenta una inestabilidad importante, el tratamiento es quirúrgico y tiene como finalidad corregir y estabilizar la vértebra protegiendo de este modo las estructuras neurológicas. Las posibilidades del tratamiento quirúrgico, se tiene que valorar con el cirujano, quien conocerá las necesidades de cada paciente e intentará al corregir la inestabilidad, asegurarse que los nervios y los discos adyacentes se mantengan en el mejor estado posible.