1. Spondylolysis

2. Definition/Description of the injury Spondylolysis is a condition in which there is a defect in the pars interarticularis of the vertebra. The pars interarticularis is a small segment of bone from the vertebral arch joining the facet joints of the spine. An MRI scan can evaluate changes in the par interarticularis to diagnose active spondylolysis or inactive spondylolysis. Active spondylolysis indicates that there is movement at the pars defect that is likely to cause low back pain, while inactive spondylolysis indicates no movement at the defect and low back pain is from another source. Patients are often advised to limit rigorous activities like sports to avoid causing advancement of the spondylolysis that may lead to the development of spondylolisthesis.

3. Cause of injury Spondylolysis develops most commonly in adolescents, most typically in 10 to 15 year olds. The majority of adolescents with spondylolysis do not have symptoms, or their symptoms are mild and are often overlooked. If the spondylolysis is not correctly identified and managed, there is a chance that the affected area may heal incorrectly, resulting in the possibility of continued stress that can lead to the slippage of spondylolisthesis and recurrent low back pain. spondylolysis spondylolisthesis Spondylolysis is seen more often in athletes than in people who do not actively participate in sports, although studies differ as to just how much more. Approximately 3% to 7% of the general population is thought to have spondylolysis. It is suspected that spondylolysis occurs most frequently in young athletes who are involved in sports that require repeated hyperextension of the lower back. One study found that spondylolysis occurred most frequently in young athletes involved in throwing, bobsledding, artistic gymnastics, rowing, and boxing

4. Cause of injury continued Another study found the highest incidence of the condition in diving, wrestling, weightlifting, modern pentathlon and triathlon, and track and field (e.g. from javelin throwing, high jump, and other activities involving hyperextension of the spine) Of course, most athletes involved in the above and other sports do not develop spondylolysis, and at this time it is not known what causes the condition to develop in some people and not in others. Older adults can also develop spondylolysis because of degeneration in the disc and the facet joints (degenerative spondylolisthesis), which can allow slippage even without a fracture. While it is not known exactly what causes this condition, it is theorized that it probably involves overloading the back part of the facet joints, which can eventually lead to stress fractures.degenerative spondylolisthesis

5. Effect on sports performance Symptoms may include: Pain across the lower back Spasms in the back and hamstring muscles Pain radiating down the leg Many people have no symptoms at all. If you have symptoms, treatment may include: Exercise Restriction Do not do athletic activities for several weeks to several months. In general, this restriction should last until the symptoms are gone. Back Brace Your doctor may suggest that you wear a back brace. This will help relieve pain. About 4-6 weeks of bracing may be needed. The brace should limit extension of the lower (lumbar) spine. Physical Therapy To relieve the pain and prevent recurrences, a physical therapist can teach you: Exercises to strengthen the back and abdominal muscles—These muscles stabilize the spine. Proper exercise and sports techniques to help prevent overuse and further injury Hamstring stretches Medication The doctor may give you medications for pain relief.

6. Effect on sports performance continued Surgery Surgery may be needed if there is: Injury to the nerve High-grade spondylolisthesis (more than 50% slippage) No relief from medicine, rest, activity modification, and physical therapy Two procedures are usually needed: Decompressive laminectomy — removal of excess bone and tissue that is putting pressure on the spinal nerves laminectomy Spinal fusionSpinal fusion —fusing together of the two involved vertebrae to prevent further slippage of the vertebra Prevention To reduce your risk of getting spondylolysis: Limit how much you participate in certain sports. This will help prevent overuse injury. Keep the abdominal and back muscles strong. Keep the hamstring muscles supple. Use proper equipment for your sport. Warm up properly before exercising or playing sports. Learn proper techniques for exercise and athletic activities. Seek medical care for chronic back pain. Early vertebral stress fractures, particularly in teens and young adults, may heal with rest.

7. Treatment Of Spondylolysis There is no treatment available to reverse the continuous process of Spondylosis, this is because it is a degenerative process (This means that through time, the affected tissue will begin to deteriorate, and lose its functional ability due to injury and/or age). The treatments for this usually take care of the back/neck pain that spondylosis can cause. So theoretically; the treatments to treat spondylosis basically are the treatments that treat back and neck pain. Treatments come in six different methods: medications (such as anti-inflammatory medications, pain medications, muscle relaxants, and some more), self-care, good exercise and physical therapy, adjunctive therapies (such as chiropractics and acupuncture), injections; or any other minimal procedures, and surgery.

8. Medical Treatment Anti-inflammatory Drugs- Or known as NSAIDS are used to eliminate any inflammation. Analgesics- Or known as pain medications or painkillers; Drugs that relieve the person who takes these of any pain. Muscle Relaxants- Muscle relaxants are not classified as a class of drugs, though rather a group of drugs that each have an effect on the body. These usually don’t work directly on the muscles, but act on the brain and considered as a total body relaxant. As stated above, there is no way to reverse the effects of spondylosis. So that means there are no existing medications that take care of spondylosis for good. To relieve the pain, one would be given either pain medications (Analgesics), anti- inflammatory medications, and muscle relaxants. NSAIDS (Nonsteroidal Inflammatory Drugs, such as: Advil, Motrin, and Aleve) are said to be effective at best when dealing with the neck pains spondylosis can cause. The drugs like Advil, Motrin, and Aleve can be available without a prescription, other than those drugs are to be taken with prescription. Muscle relaxants that one could take are: Flexeril, Zanaflex, Soma or Valium. To relieve pain, the individual can take: Tylenol, Ultram, or most NSAIDS provided. There are many more medications of each kind, but these were just a few.

9. Adjunctive Therapy and Exercise The doctor may then prescribe for the affected individual to undergo physical therapy if the neck/back pain does not become better on its own. The doctor might tell one with the back/neck pain to undergo physical therapy to strengthen and stretch out the muscles. Once in physical therapy, the teacher will teach the person of many different methods to help strengthen the back, and prevent some reoccuring pain. Exercising daily is also a good and beneficial way of stopping the pain. Exercises like yoga, walking/running, jumping jacks, and more can be effective. One way an affected person may get treated is by undergoing acupuncture. Acupuncture is a method of treating a large variety of illnesses. Acupuncture involves the inserting of needles into very specific points of the area of pain. World Health Organization (WHO) recommends this method, to be used on many different ailments. One other way to treat the pain of spondylosis is to visit a chiropractor. A chiropractor is an individual whom has a profession to diagnose neuromuscular disorders (Neuromuscular relating both Nerves and muscle, usually found near the spine, in this case, a neuromuscular disorder is a disorder around the spine). The chiropractor’s main goal is to reduce pain, as well as improve on the patient’s functionality.

10. Surgery to Treat Spondylosis There are many types of surgical procedures to treat spondylosis. Here are four types of surgery one can sustain. One should only take surgery if the doctor instructs you to do so. Most likely after when all other methods of treatments fail to eradicate pain. -Spinal Fusion: Spinal fusion is the surgical procedure in which bone graft material (Bone graft are materials that are used to substitute bone. Bone graft is most often used when there are fractures, or defects on the bone. This speeds up the healing process) is placed onto defects of the vertebrae. This is used to fix up displaced vertebrae, and increase spinal stability. -Facetectomy: a combination of two words; Facet (facets are small joints that reside within your spine, they stabilize the spine.) and ectomy (means remove/removal of). This procedure has the surgeon remove some facet joints to diminish the pressure. -laminectomy: There is a bone that protects the spinal canal and the spinal cord; it is called the lamina. In some situation, the lamina might be resting on the spinal cord, causing some neural dysfunctions. The surgeon in this situation will make room for the spinal cord, and remove parts of the lamina. And there are a lot more, too much to put in this presentation.

11. Prevention of Spondylosis There are three major ways of getting spondylosis. These are old age, obesity, and family history. Obesity is the only avoidable cause, while all other causes depend on age or if your family has gotten it before. Though you can prevent it by living a undoubtably healthy life. Here are some tips to minimize the risk of spondylosis and live a nice spondylosis-free life: -Eat nutritiously: providing you body with a nice bunch of vitamins/minerals help maintain healthy tissues, like cartilage and bone. So your spine call withstand wear and tear, and withstand degeneration -Exercise: Lifting some weights has been said to have increased bone density, not only that, but muscle is more prone to burn calories than fat. So you are also losing weight by doing this. -Stretch often: By stretching, you are relieving the spine of pressure from tense muscles, and avoiding future injuries by becoming a bit more fit for the day.

12. Short Test 1.In which group of individuals is spondylosis is most common in? a) Athletes b) Adolescents c) Babies d) A and B 2. How is spondylosis caused? a) Old age b) Getting too many pats on the back c) Obesity d) A and C 3. What is Spondylosis? a) A defect in the pars interarticularis of the vertebrae b) Heart disease c) A game d) B and C 4. Is surgery a go to method to relieve Spondylosis? a) Surgery must be done right away without doctor’s orders b) No, you don’t need surgery to relieve Spondylosis c) Only after any other method has failed, and when doctor tells you to d) After a year 5. Can you recover from Spondylosis? a) Yes, you only need some good rest b) Spondylosis is a degenerative process and can’t be cured easily c) Take lot’s of pills 6. Name a type of pill that should be used for medical treatment a) Analgesics b) Muscle Relaxtants c) Anti-Inflammatory drugs d) A,B and C

13. Short Test (Continued) 7. What is a symptom of Spondylosis? a) Major rash b) Pain across the lower back c) Nothing bad d) A broken leg 8. What could prevent this injury? a) Eating lots of nutritious food b) Nothing c) A lot of sleep d) Exercise e) A and D 9. What is an Analgesic? a) Pills used to relieve pain b) Pills used to put one to sleep c) A drink d) A part of your body 10. What is the Pars Interarticularis? a) A small segment of bone from the vertebral arch, which joins the facet joints of the spine b) A bone of the leg c) A french word d) A part of the brain that coordinates voluntary muscle Short Questions 1.What kind of physical and nutritious foods activities could you do/eat to prevent Spondylosis? 2.What is a ‘Degenerative Process’? 3.Why can’t Spondylosis be cured? 4.What are some of the adjunctive methods of recovery? 5.Why would elders contract Spondylosis?

14. Bibliography sites used by Michael: "Spondylolysis." Spine-health. N.p., n.d. Web. 28 Feb. 2016.. "EasyBib: The Free Automatic Bibliography Composer." EasyBib. N.p., n.d. Web. 28 Feb. 2016.. Hyde, Thomas E., DC, DACBSP, CKTP, and FRACCSS (Hon). "Profile and Diagnosis of Spondylolysis." Spine-health. Spine- health.com, 07 Aug. 2004. Web. 28 Feb. 2016.. "Pain Health Center | Lifescript.com." Related Health Issues |Conditions With Symptoms of Pain. EBSCO Publishing, 2013. Web. 29 Feb. 2016..

15. Bibliography Sites used by Jonathan http://www.emedicinehealth.com/spondylosis/page6_em.htm#spondylosis_treatment http://www.myspinedoc.com/spondylosis http://medical-dictionary.thefreedictionary.com/bone+grafting ‘ https://www.laserspineinstitute.com/articles/spondylosis/prevent/515/ http://www.medicinenet.com/script/main/art.asp?articlekey=34038 http://www.spine-health.com/treatment/chiropractic/what-a-chiropractor http://www.emedicinehealth.com/spondylosis/page9_em.htm

16. Short Test ANSWERS 1.In which group of individuals is spondylosis is most common in? a) Athletes b) Adolescents c) Babies d) A and B 2. How is spondylosis caused? a) Old age b) Getting too many pats on the back c) Obesity d) A and C 3. What is Spondylosis? a) A defect in the pars interarticularis of the vertebrae b) Heart disease c) A game d) B and C 4. Is surgery a go to method to relieve Spondylosis? a) Surgery must be done right away without doctor’s orders b) No, you don’t need surgery to relieve Spondylosis c) Only after any other method has failed, and when doctor tells you to d) After a year 5. Can you recover from Spondylosis? a) Yes, you only need some good rest b) Spondylosis is a degenerative process and can’t be cured easily c) Take lot’s of pills 6. Name a type of pill that should be used for medical treatment a) Analgesics b) Muscle Relaxtants c) Anti-Inflammatory drugs d) A,B and C

17. Short Test (Continued) 7. What is a symptom of Spondylosis? a) Major rash b) Pain across the lower back c) Nothing bad d) A broken leg 8. What could prevent this injury? a) Eating lots of nutritious food b) Nothing c) A lot of sleep d) Exercise e) A and D 9. What is an Analgesic? a) Pills used to relieve pain b) Pills used to put one to sleep c) A drink d) A part of your body 10. What is the Pars Interarticularis? a) A small segment of bone from the vertebral arch, which joins the facet joints of the spine b) A bone of the leg c) A french word d) A part of the brain that coordinates voluntary muscle Short Questions ANSWERED 1.What kind of physical and nutritious foods activities could you do/eat to prevent Spondylosis? You can eat foods, like grapes, apples, carrots, oranges, bananas and pears. Some physical activities you could do are lifting weights, back exercises, and many more. 1.What is a ‘Degenerative Process’? Through time, affected tissue of an injury/ailment may lose its main function and deteriorate. 1.Why can’t Spondylosis be cured? It is a degenerative process, so it cannot be cured directly due to this. By the time it has been caused, the tissue of affection have lost their functional ability. 1.What are some of the adjunctive methods of recovery? You can go to a Chiropractor, or an acupuncture. 1.Why would adolescents be able to get Spondylosis? Either it be from playing sports, or gaining weight.