The prevalence has been reported to be between 4 and 8% of all children.
It is thought to be even more common in athletes.
With more young athletes specializing earlier and participating in year-round sports, spondylolysis is being seen in younger children.
Most often, repetitive stress from activities requiring excessive lumbar extension is contributory
Sports at increased risk include: gymnastics, baseball, football (linemen & linebackers), dancers, weightlifters
Spondylolysis is thought to be responsible for almost 50% of back pain in this population!
Commonly involves L5.
When these fractures occur bilaterally the superior vertebral body can translate anteriorly on the vertebrae below, a process called spondylolisthesis.
Unlike most causes of back pain that are worse with flexion, patients will often have increased pain with extension.
-Back extension loads the posterior elements of the spine.
Treatment focuses on modifying activities that cause pain, avoid back extension, NSAIDs for pain control and physical therapy for improved core strengthening & flexibility.
For athletes, initial recommendation is for a six-week period of rest
