Spondylolisis

Spondylolysis is a pathology of the vertebral column (not the vertebral disc). It consists of an affectation of the joint produced by a fissure or fracture (hence the term -lysis) that by itself produces pain, but being in an environment with good musculature and joint tissues such as ligaments and correct cartilage, it can simply pass as a picture of lumbar pain and in the most serious cases, with neurological affectation producing pictures similar to those of a lumbosciatica.

They are almost always caused by movements that exceed the usual ranges of motion, or by presenting direct or indirect trauma to the back. The joints are located at the back of the vertebrae (posterior face) and are the ones that allow the vertebrae to be kept in their correct place as a hinge on a door with a frame would, in an everyday comparison. In the same way, the injury is classified in degrees of severity, if it is in a single vertebra, on a single right or left side, or if it involves more vertebral segments, increasing in these cases, the possibility that the segment becomes unstable and consequently, produce a displacement, as would a fracture in any other part of our skeleton

The symptoms can be variable, but it is generally a sharp and localized pain, as a result of a trauma or gesture of forced movement, although it can also be due to a genetic defect. If the fracture is very important, it can produce a condition with neurological involvement and a displacement, leading to complement its diagnosis as SPONDYLOLYSTESIS. It is true that the 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 CT, due to its great capacity to identify bone tissue, but Magnetic Resonance is not far from the first site, as it allows us to confirm if there is involvement of the rest of the joint, allowing the tissue to be assessed very correctly neurological, disc and muscular

At first, conservative treatment becomes useful, especially if we combine it with a lumbar girdle with posterior reinforcement (in case of lumbar level) a collar (in case of cervical), and that the stability of the segment and that there is no associated neurological injury. It is treated with anti-inflammatories, muscle relaxants, and rest. When the initial treatment has not been optimal, or the segment presents significant instability, the treatment is surgical and its purpose is to correct and stabilize the vertebra, thus protecting the neurological structures. The possibilities of surgical treatment must be evaluated with the surgeon, who will know the needs of each patient and will try to correct the instability, to ensure that the nerves and adjacent discs are kept in the best possible state.