Possible causes

Spondylolysis occurs in 80 % of cases in the lumbar spine area in the 5th lumbar vertebral body. The 4th lumbar vertebral body is the second most frequently affected vertebral body. Spondylolysis is extremely rare in other spinal column sections such as the thoracic spine or cervical spine.

It is often promoted by congenital spinal deformities and then occurs in childhood or adolescence. Children with a severe hollow back are often affected. Certain sports such as gymnastics or butterfly swimming, which require an increased hollow back, can promote the development of spondylolysis.

Severe symptoms often do not appear until adulthood. In the case of acquired spondylolysis, a fracture can be caused by chronic, long-term stress (fatigue fracture); rarely, metastatic tumors can also lead to spondylolysis. Spondylolysis can lead to back pain and tension.

An incorrect posture in favor of a hollow back is also common. Pain occurs particularly after strains where the back is loaded in extension. Due to the lack of stability of the vertebral body, the muscles have to work increasingly against the posture and tense up quickly. The articles “Spinal canal stenosis” and “Back pain – not with a strong back” might also be of interest to you in this regard.

Operation

Surgery may be indicated for therapy-resistant permanent pain or nerve involvement. If a nerve is compressed by spondylolisthesis and pain radiates into the leg, for example, surgery should be considered in order to avoid permanent damage to the nerve. Surgical removal of certain elements of the vertebral arch can be performed (laminectomy) to relieve the compression of the nerve.

Frequently, the stabilizing fusion surgery is also used. In this procedure, the unstable vertebral body is fixed to the vertebra above by means of fixing material, thus stabilizing it. The disadvantage of this surgical technique is that the mobility in this segment is completely eliminated and other spinal segments must compensate for this loss.

In cases of severe spondylolisthesis, however, this can be accepted in order to improve the patient’s symptoms. The operation is usually followed by immobilization with a corset for a few weeks, followed by intensive physiotherapeutic follow-up treatment to strengthen the muscles again. During this process, stability is trained, but also the mobility of the back is worked out, so that after the operation the most physiological movement of the back is possible again. You can find more good exercises under mobility training – spine, shoulder, knee, hip.