Vertebral Fractures & Slippage: Spondylolysis, Spondylolisthesis

For most patients with spondylolysis and spondylolisthesis, back pain and other symptoms will improve with conservative treatment. – OrthoInfo 

Spondylolysis (Vertebral Arch Fracture)

  • Usually occurs in lower lumbar spine, especially L5. May also occur in cervical spine.
  • Often caused by repetitive trauma, especially hyperextension.
  • It may occur in people of all ages but children and adolescents are most at risk because their spines are still developing.
  • “The injury most often occurs in children and adolescents who participate in sports that involve repeated stress on the lower back, such as gymnastics, football, and weight lifting.” (OrthoInfo) Wikipedia cites research attributing 50% of all low back pain among young athletes to spondylolysis.

Spondylolisthesis (Vertebral Slippage)

  • This is the name given when a vertebral arch fracture weakens the bone so much that the vertebra starts to shift or slip out of place.
  • It usually occurs in the lower lumbar spine.
  • Both spondylolysis and spondylolisthesis are more likely to occur in young people who participate in sports that require frequent hyperextension of the lumbar spine such as gymnastics, football, and weight lifting.
  • Baxter Bell MD points out here that knowing the direction of the slippage is needed in order to identify which movements are safe. In most people, the vertebra slips forward of the one just below it (anteriolisthesis). Fewer experience a backward slippage (retrolisthesis).

Potential Causes

There are many causes for spondylolisthesis. A vertebra might be defective from the time a person is born, or a vertebra may be broken by trauma or a stress fracture. In addition, vertebrae can be broken down by infection or disease. Commonly, this disorder occurs in children and adolescents who are active in athletics, such as gymnastics. – WebMD

  • A common cause is repetitive trauma leading to a stress fracture
  • Sudden injury or trauma
  • Congenital
  • Arthritis or other age-related conditions
  • Infections of the spine