Pediatric Spondylolysis & Spondylolisthesis

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Pediatric orthopedics encompass a wide range of spinal conditions, including spondylolysis and spondylolisthesis, which can affect growing children and adolescents. These conditions involve structural abnormalities in the spine that require careful diagnosis, treatment, and monitoring to ensure optimal spinal health. In this article, we explore the intricacies of pediatric spondylolysis and spondylolisthesis, shedding light on their causes, symptoms, and available treatment options.

Pediatric Spondylolysis: Cracking the Code

Spondylolysis refers to a stress fracture that occurs in a specific part of the spine, known as the pars interarticularis. This condition is common among young athletes engaged in activities that involve repetitive extension and rotation of the spine, such as gymnastics, football, and dancing.

Causes and Risk Factors:

The repetitive stress placed on the lower back during sports or physical activities is a primary cause of spondylolysis. Factors such as muscle imbalances, poor technique, and rapid growth spurts can increase the risk.


  • Lower Back Pain: Persistent pain in the lower back is the hallmark symptom. It often worsens with activity and improves with rest.
  • Tight Hamstrings: Tightness in the hamstring muscles can be an associated symptom.
  • Limited Range of Motion: Some children may experience difficulty bending backward or performing certain movements.

Diagnosis and Treatment:

Diagnosis involves a thorough physical examination, medical history review, and imaging studies like X-rays or MRI scans. Treatment options vary based on the severity of the condition and the child's symptoms. Conservative approaches include rest, physical therapy, and temporary activity modification. In more severe cases, bracing might be recommended to provide additional support during the healing process.

Pediatric Spondylolisthesis: When the Spine Shifts

Spondylolisthesis occurs when a vertebra slips out of its normal position and onto the vertebra below it. In children, the condition is often due to spondylolysis weakening the pars interarticularis, allowing the vertebra to slip forward.

Causes & Risk Factors:

Spondylolysis is a common precursor to spondylolisthesis. Rapid growth during adolescence, combined with a genetic predisposition and participation in activities that strain the spine, can increase the risk.


  • Lower Back Pain: Pain is a common symptom, often exacerbated by activity.
  • Leg Pain: In more severe cases, leg pain or sciatica might occur due to nerve compression.
  • Muscle Weakness: Weakness in the legs can result from nerve compression.

Diagnosis & Treatment:

Diagnostic measures include a physical exam, medical history assessment, and imaging studies like X-rays, MRI, or CT scans. Treatment options depend on the severity of the slippage and its impact on the child's daily life. Conservative management includes activity modification, physical therapy, and bracing. Surgery might be considered in cases of severe slippage or persistent pain that doesn't respond to conservative treatments.

The Road to Recovery:

For children diagnosed with pediatric spondylolysis or spondylolisthesis, a thorough evaluation by a pediatric orthopedic specialist is paramount. Early intervention, appropriate management, and tailored treatment plans are essential to ensure a successful recovery and the best possible spinal health outcomes.

At Paley Institute Spine Center, Drs. Feldman, Shufflebarger, and Hariharan are committed to guiding young patients and their families through every step of this journey, fostering optimal spinal well-being for a brighter future. Contact us to schedule an appointment.

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