When back pain severely interferes with normal life, the cause may be either Spondylolysis or Spondylolisthesis. Although they may sound similar, one is actually a more advanced version of the other. These conditions are caused by the spinal bones (vertebrae) moving out of their proper alignment, often resulting from a fracture.
Spondylolysis is defined as a stress fracture in the bones of the spinal column, while spondylolisthesis is a stress fracture that weakens bones so they are unable to maintain their proper position, resulting in shifting.
Similarities and Differences Between Spondylolysis and Spondylolisthesis
While spondylolysis is considered the most common reason for lower back (lumbar) pain among adolescent athletes, research shows that it affects 3% to 6% of the entire population. Spondylolysis of the spine is a frequent culprit when it comes to those conditions that appear in X-rays. The fifth lumbar vertebra is the usual target for spondylolysis, but patients may also develop this condition in their fourth lumbar vertebra.
Contrastingly, spondylolisthesis is more common among adolescents and adults. In severe cases of spondylolisthesis, the vertebral bones may eventually press on corresponding nerves. This scenario may call for surgery to correct the positioning. This condition may develop anywhere along the spine, although the lumbar region is the most common area.
Causes of Spondylolysis and Spondylolisthesis
Generally, both of these spinal conditions are thought to develop either because they are inherited, or as a result of overuse. On a hereditary basis, research suggests that spondylolysis is more likely to develop because individuals who are born with thin vertebral bones may be more vulnerable. Additionally, certain sports and activities stress the lower back’s bones and continually overstretch/hyperextend the spine. For example, sports such as football, gymnastics, and weight-lifting, may contribute to spondylolysis and spondylolisthesis formation. This often results in a stress fracture on one or both vertebral sides. Those men and women who experience significant periods of rapid growth may also be at risk for having vertebral slippage.
Symptoms of Spondylolysis and Spondylolisthesis
These conditions may exist, although one may not experience any symptoms. When symptoms do occur, patients often feel pain much like a muscle strain spreading across the lower back. Heavy exercise or activity may also worsen spondylolysis back pain. New spondylolisthesis may be accompanied by an upper back ache and spasms that stiffen and tighten the hamstring muscles. Patients may also notice changes to their gait and posture, and physicians report that spondylolisthesis may narrow the spinal canal, causing nerve compression.