Spondylolysis is a medical term used to describe a hairline fracture in the bony arch that is located on the back of a vertebra. This most commonly occurs in children and adolescents, according to eOrthopod.
Treatment is initially conservative and entails rest, bracing and physical therapy. When these options fail to provide relief from the pain and stiffness associated with spondylolysis, surgery may be recommended. Patients should be informed of the possible complications of such surgery.
Spinal Instability
Laminectomy, one of the surgical procedures used to treat spondylolysis, can increase instability in the spine in up to 10 percent of those who undergo the procedure, according to Dr. Peter Ullrich of Spine-Health. The procedure involves surgical removal of part of the bony arch of the vertebra. This removal can weaken the integrity of the joint and lead to slippage of the vertebra.
When this occurs, further surgery may be needed to reinforce the spine. Spinal fusion surgery is sometimes used following a laminectomy that has caused instability of the affected segments.
Degeneration of Adjacent Vertebrae
Spinal fusion surgery is another procedure that can be used to address spondylolysis of the lumbar spine. This surgery is aimed at fusing two vertebral segments so that they grow together as a single unit. In order for the bones to fuse, the cartilaginous intervertebral disc, which provides shock absorption and allows freedom of movement between the vertebrae, is removed. Then a bone graft is applied to the two adjacent vertebrae, and in some cases, metal plates brace them until the bones heal together as one.
The disadvantage of spinal fusion surgery in treating lumbar spondylolysis is that it places additional load on the vertebrae above and below the fused segments. This may cause degeneration of those segments and lead to more pain and spinal instability.
Failed Back Surgery Syndrome
Failed back surgery syndrome is the term used in cases where surgery has failed to relieve the symptoms that prompted the procedure. Ullrich notes that objective diagnosis of this syndrome is hard to come by. Scar tissue revealed in an MRI scan may be the only finding, though such scar tissue can also be seen in the MRI scans of back surgery patients with no recurring pain. Improper patient screening, recurrent disc herniation or surgical error may be at fault in some cases of failed back surgery syndrome.
