Back pain is a common complaint in people of all ages. Whether it be due to old age, athletics, or a random accident, back pain can significantly impact an individual’s life. Another frustration that is common when dealing with back pain is the potentially confusing medical terms that are used to diagnose the pain. It is particularly difficult when trying to understand and differentiate spondylosis, spondylolysis, and spondylolisthesis. While they may all have “
Spondylosis: What is it? And how is it caused?
The spine is a series of bones with unique joints between each. These joints allow for flexion, extension, rotation, and side bending. However, just like any other joint, this can lead to degeneration and the development of arthritis. In spondylosis, the degeneration and arthritis that can cause compression of the spinal cord or of the nerves as they leave the spinal column. This will often present with sensory loss, difficulty with movement, pain, numbness, or muscle weakness. Spondylosis most commonly occurs in the neck region, so often the symptoms are most apparent in the neck, shoulder
Just like other forms of arthritis, spondylosis is primarily caused by wear and tear, usually due to older age. While age is the greatest risk factor for developing spondylosis, any activity or force that places more stress on the spine can increase the likelihood of development. This includes sports like football, weight lifting
Spondylosis Prevention and
While young, avoiding risk factors can be very helpful in preventing
When diagnosed with spondylosis, usually the medical provider will recommend non-invasive conservative therapy. This will often include NSAIDs and physical therapy. In addition, activities such as yoga or massage can be helpful. Generally, surgery is only reserved for those who have significant symptoms from the spondylosis and who are not responding to the non-invasive treatments, including injection therapy.
Spondylolysis: What is it? And how is it caused?
Spondylolysis is a stress injury, meaning that it occurs gradually over time due to chronic stress. This stress will lead to a fracture that specifically occurs at the pars
The typical individual who will develop a spondylolysis is an athlete who has repetitive backward bending in their sport, which is common to gymnastics, dancing, football (especially linemen), wrestling, and many more. Adolescence, during which rapid growth is occurring, and inflexibility, such as tight hip flexors and hamstrings are also common risk factors for developing this injury.
Spondylolysis Prevention and Treatment
There isn’t much that can be done to prevent a spondylolysis. Maintaining good core strength and avoiding excessive
Despite being a fracture, spondylolysis can be treated conservatively in most cases. Treatment typically includes a period of restriction from activity and physical therapy. While the patient may still be able to participate in aspects of their sport, it is important to allow the bone to heal through rest, while at the same time strengthening the core through physical therapy to make sure the injury does not recur. Re-injury is uncommon when treated properly and taking measures to build core strength and improve flexibility.
Bracing can be used in more acute injuries, or in chronic injuries that have not been able to heal as would be desired. The most typical brace is the “Boston Overlap Brace” or BOB. It is a rigid plastic custom-fit brace and will immobilize the spine in a neutral position so that it is able to heal without aggravating movements that would prevent the back from healing. Some people will transition into a soft flexible brace, but will only be used initially during
Should non-invasive therapies including activity restriction, bracing and physical therapy not work, surgery may be indicated in people with significant symptoms. Pedicle screws can be placed to close the gap of the fractured bone, which prevents future progression and in most cases treats pain. Before considering surgery it is important to make sure pain is due to the fracture, and not to facet joints (“facet arthropathy”), sacroiliitis, interspinous impingement or other cause
Spondylolisthesis: What is it? And how is it caused?
- Grade I: 0-25%
- Grade II: 25-50%
- Grade III: 50-75%
- Grade IV: 75-100%
- Grade V: greater than 100%
Spondylolisthesis Prevention and Treatment
Prevention and treatment for
By Zac Taylor & Jon Minor, MD
Cervical Spondylosis Prevention. (n.d.). Retrieved from https://my.clevelandclinic.org/health/diseases/17685-cervical-spondylosis/prevention
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Kim, R., Singla, A., & Samdani, A. F. (2015). Classification of Spondylolisthesis. Spondylolisthesis,95-106.
Pathogenesis of myelopathy in cervical spondylosis. (1975). Injury,7(2), 161.