Health Report


Health Report Essay, Research Paper

Q: My 15-year-old son plays hockey and soccer and has just been diagnosed with spondylolisthesis minimal slip) by a bone scan. The doctor said this was caused by overuse. Currently, my son has lower back pain (no leg pain).

A: Spondylolisthesis is a forward or backward slippage of one vertebra (spinal bone) upon another. Based upon your information, I assume that your son’s problem is in the lumbar spine (low back). Please keep in mind that without an actual physical examination I cannot provide more than general information.

The vertebrae are held in alignment by a number of different structures, including the intervertebral discs, tough fibrous ligaments and small joints at the outer rear of the spine called facet joints. All of these structures handle tremendous forces, particularly in the lumbar spine, and particularly in persons involved in vigorous sports activities such as hockey or gymnastics.

In teenagers, spondylolisthesis most often occurs when a bony structure called the Pars Interarticularis, which bridges one facet joint to another, fractures under stress. This allows the affected vertebra to slide forward in relation to the others, causing pain. Pain is usually worse with any attempt to bend backward (extend the spine) and improves with leaning forward (flexion). Par fractures often show up on plain X-rays, but where they are not obvious on X-ray they usually show up on a bone scan.

For the young patient with spondylolisthesis, we usually recommend a carefully prescribed program of rehabilitation, usually starting with physical therapy, to teach an appropriate exercise program. Exercises focus on improving posture, strengthening postural muscles such as the abdominals and improving flexibility. Sometimes a lumbar support or brace is needed early in the course of treatment. The Pars fracture may heal; in many cases, it does not, but ceases to become painful. Most young people with this problem do quite well with appropriate treatment.

A physiatrist (rehabilitation specialist) or other physician can prescribe an appropriate rehabilitation program with expertise in sports medicine and spinal disorders.

If your son undergoes an appropriate rehabilitation program, he may eventually be able to make a return to sports. He may need to wear a back support when participating in vigorous exercise. Whether he returns to his full pre-injury activities will depend upon the exact nature of his injury, his response to treatment and his discussions with his doctor. (January 31, 1998)


I thought that this article was very interesting. I feel extremely bad for this child because I know how sports can control your life and when their taken away so is your life. This article should you about rehabilitation and physical exercises you can do to help heal a major injury.

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