Spondylolysis

• Fracture through the pars interarticularis portion of the posterior vertebral elements
• Usually at the level of L5
• increased incidence in sports which involve back hyperextension
• PE significant for pain on lumbar hyperextension
• DX with AP/lateral/oblique views of the LS spine
• Bone scan useful to estimate age of fracture (old fracture if there is no increased activity on bone scan)
• Management: rest with gradual return to sports for old fractures; immobilize with TLSO or cast for 3 mos with newer fractures

Also see Scheuermann Disease, Kyphosis. 30-50% of these patients have spondylolysis
Also see Spondylolisthesis

CHLA Board Review 2005