The most common cause of low back pain in adolescent athletes that can be seen on X-ray is a stress fracture in one of the bones that make up the spinal column. This condition is called spondylolysis (spon-dee-low-lye-sis).

If the stress fracture weakens the bone so much that it is unable to maintain its proper position, the vertebra can start to shift out of place. When one vertebrae slips forward on the adjacent vertebrae the condition is called spondylolisthesis. If too much slippage occurs, the bones may begin to press on nerves. This condition can be the source of back pain, leg pain and other symptoms. Surgery may be necessary to for spondylolisthesis treatment.

The causes of Spondylolysis and Spondylolisthesis:


There may be a hereditary aspect. An individual may be born with thin vertebral bone. Significant periods of rapid growth may encourage slippage.


Some sports such as gymnastics, weight lifting and football put a great deal of stress on the bones in the lower back. This can cause a stress fracture on one or both sides of the vertebrae.

Nonsurgical Spondylolysis and Spondylolisthesis Treatment:

Your doctor will be able to discuss with you what your diagnosis means in terms of treatment options. For most people without any signs of nerve compression or other neurologic impairment, the first line of spondylolysis and spondylolisthesis treatment consists of non-surgical therapies such as

  • Physical Therapy
  • Bracing
  • Epidural spinal injections
  • Anti-inflammatory medications

Surgical Options:

Spine surgery is typically considered only after conservative therapies fail to adequately relieve symptoms over a significant period of time, or if evidence of nerve involvement, such as numbness or tingling, muscle weakness or bowel or bladder impairment, develops.

Surgical procedures that may be recommended for Spondylolisthesis treatment include:

  • Spinal decompression, a procedure in which bone is removed to eliminate nerve pressure
  • Spinal fusion, a procedure in which bone graft material is placed between vertebrae to join – or fuse together – the vertebrae to restore spinal stability

The spondylolisthesis treatment procedures are typically performed together as part of the same surgery, the overall goal of which is to stop the slippage, remove the source of irritation and inflammation and restore the stability of the spine.

The benefits of spine surgery, however, must be weighed against the risks. Discuss with your surgeon the risks and benefits of surgery, and the potential results of operative versus non-operative spondylolysis and spondylolisthesis treatment.

Other common procedures for Spondylolysthesis treatment include:

  • ALIF – Anterior Lumbar Interbody Fusion
  • Spinal Fusion Surgery
  • TLIF – Transforaminal Lumbar Interbody Fusion
  • Minimally Invasive Lumbar Fusion
  • XLIF – Extreme Lumbar Interbody Fusion