Mariyam Raza

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Definition: Spondylolysis is a defect or stress fracture in the pars interarticularis of a vertebra, most commonly at L5.

### Causes

* Repetitive stress and microtrauma.

* Repeated lumbar extension and rotation.

* Sports such as gymnastics, football, and weightlifting.

### Clinical Features

* Low back pain, especially during lumbar extension.

* Pain increases with sports or physical activity.

* Local tenderness over the affected vertebra.

* Hamstring tightness may be present.

### Diagnosis / Investigations

* X-ray: Oblique view may show the Scottie dog sign with a defect or collar.

* CT scan: Best for detailed assessment of the bony defect.

* MRI: Helps detect an early stress reaction and assess soft tissues.

### Management

* Conservative treatment: Rest from aggravating activities and activity modification.

* Physiotherapy: Core stabilization, gradual strengthening, flexibility exercises, and avoiding painful lumbar hyperextension.

* Bracing: May be considered in selected cases.

* Surgery: Rarely required if symptoms persist despite appropriate treatment.

### Important Exam Point

Spondylolysis = defect in the pars interarticularis.

If the affected vertebra slips forward over the vertebra below it, the condition is called spondylolisthesis.