When talking about alterations in the structure of the spine due to back pain, It is important to take into account whaté it is about and whaté is the spondylolysis. Spondylolysis consists of rupture of the láv mineértebra, so that the jointón facet is separated from the rest. At véThe most frequently affected vertebra is the fifth lumbar, continued from the fourth.
In most cases when spondylolysis affects the fourth lumbar, a sacralization is generatedón of the fifth lumbar.
In this sense it is necessary to know that young people areá más exposed to its development, since his bones are locatedún growing. The niñand adolescents who do sports or other activities fíphysical exercises that can strain the lower back or involve bending the back, especially backwardsás, like ballet, golf, wrestling or fúamerican football, son más prone to its development.
Index
Cóhow spondylolysis occurs
in the majoríto the occasions, spondylolysis is not a true tear in itselfí the missus, but the bone does not form. In this type of case, la separationón between the jointón facet and the rest of the lámine exists from birth and is constantly maintained throughout his life.
On other occasions, in which the bone becomes formed in the correct way, theávertebral mine ruptures as a result of trauma or caídas that are given repeatedly. This happens regularly to athletes and usually takes between 6 u 9 months to recover spontaneouslyánea.
Sísymptoms of the spondylolysis
On a regular basis, spondylolysis does not cause anyún síntoma is in pain; and is only found by a chance finding on a radiographía while trying to detect another problem. This occurs especially in those spondylolysis that appear as a consequence of a defect in the formationón a bone.
The spondylolysis that appear as a result of a repeated fracture or trauma can lead to pain in the vertebral area. Therefore, the demonstrationóJust because there is a spondylolysis in a patient with back pain does not mean that this is the one that is truly causing their pain; and in fact, it is only considered to be this case, in those in which it is given by a fracture that has taken place recently.
Risks
When spondylolysis occurs on the left and right sides at the same time, there is a risk, since I saw herévertebra mayíto get to slide back and forthás, appearing what is known as spondylolisthesis. Nevertheless, this does not happen every time; and spondylolysis can usually be observed in healthy people without them suffering anyún kind of discomfort or pain from it.
Diagnóspondylolysis
For diagnosis of spondylolysis, the health professional will take careá to do an explorationón física, during which to pressá the patient's back or you will be askedá to flex backwardsás, so that the spine can be hyperextended. In the event that something is foundún kind of pain when doing it, it may be a fracture.
Other issues, like muscle pain, pinched nerves or compressed and herniated discs that bulge alsoén can cause pain in the lower back. To rule out these options or to confirm the diagnosisóof spondylolysis the health professionals orderáno tests like radiographería.
Similarly, it may be advisable to carry out a gamma graphía ósea, to which to resortá in these cases:
- To confirm the existence of spondylolysis when the radiographídoes not show it clearly, or when looking to rule out general diseases such as fever or infections.
- To distinguish whether spondylolysis has to do with a lack of trainingón of the bone or is it a consequence of a break. If it is due to lack of trainingóno bone, the gammagrafía is normal. In the case of spondylolysis due to bone breakage, the gammagrafía is capable of detecting breakage during 7 días from the moment in which the breakage has taken place.
- In order to monitor the healing processóno of the bone, in spondylolysis that is due to ruptures due to repeated trauma, scintigraphy can be usedía. In this way, information can be obtainedón to define the moment in which an athlete, for instance, can go back to training.
Treatment of spondylolysis
In cases in which spondylolysis occurs due to a formation defectóno of the bone, and there is no spondylolisthesis associated with it, nothing should be done as treatment. In these cases, it is considered that spondylolysis is not a disease, rather it is a finding that has taken place by chance.
In spondylolysis cases, it is caused by the breakage of a bone, from repeated fracture or trauma, It is convenient that efforts be reduced or suspended until recovery is achieved.ón, especially in the case of athletes, intense workouts.
In this sense, can indicate the corsé for patients in whom spondylolysis is caused by a bone break and not by lack of formationón; and when pain persists despite reduced activity and treatment. It is necessary to take measures to prevent muscle atrophy from occurring; and then goá withdrawing the hearté progressively as soon as possible.
Spaghettiéit is not possible to resort to surgeryía, Although it is indicated only in those cases in which the pain persists despite the treatments that have been applied during a period of 9 months; or if it has been proven that it is due to spondylolysis due to bone breakage and that it does not resolve 9 months laterés.
