Cervical Spondylolysis: Fractures of the Cervical Vertebrae

Many people have cervical spondylolysis and are not aware of it because they lack symptoms. If a person does experience any issues, the condition is usually minor. The most common sign of spondylolysis is pain. The pain may:

• Spread across the back
• Feel similar to a muscle strain
• Worsens with extension and rotation
• Inhibit daily activities
• Limit spinal cord movement

Because cervical spondylolysis is rarer than the form affecting the lumbar region, its symptoms are less documented. Most people report occipital headaches (at the base of the skull), loss of neck movement, and pain while moving. Experts associate these issues with the mechanical instability and muscle spasms that cervical spondylolysis causes. Behaviorally, the loss of stability leads to actions like resting the head on the hands or laying it on a table.

While the symptoms of spondylolysis stem from defects or stress fractures in the vertebral arch, experts are not aware of the direct cause. Research has found several factors that may contribute to the condition. Performing strenuous activities as a child or young adult appears to play a role. Certain genetic traits that cause inherent weakness may also be responsible.

Experts have also recognized certain risk factors of spondylolysis. Males are more likely than females to have the condition, though this may be due to cultural factors leading to more males playing traumatic sports. Genetic and structural factors, such as weaker vertebrae, may contribute as well. Cervical spondylolysis might occur due to neck injuries or occupations requiring overhead work or frequent neck movements.

A doctor typically begins the diagnostic process with questions about symptoms and medical history. For spondylolysis, medical imaging is the most useful tool for confirming a diagnosis or detecting other issues. X-rays can show if there are any fractured vertebrae. CT and MRI scans can reveal smaller fractures and help rule out other diagnoses.

Treatment for spondylolysis, especially of the cervical variety, is extremely variable. Physical therapy involving extension and flexion exercises, along with neck strengthening and flexibility activities, is typical. Doctors may use steroid injections or prescribe nonsteroidal anti-inflammatory drugs for pain relief. A brace can help stabilize the vertebrae as the fractures heal.

Most cases of spondylolysis do not require surgery. However, some people need surgical intervention to help stabilize their spines. Pars repair surgery is the most common; the surgeon removes scar tissue from the area and uses bone from somewhere else in the body to repair the fracture. Physical therapy and rehabilitation are necessary after the surgery.

Some people with spondylolysis may develop spondylolisthesis, where a vertebra becomes displaced. Symptoms of spondylolisthesis in the cervical vertebrae include neck stiffness, numbness, and muscle weakness. The neck may be unusually curved or require manual support.

Cervical spondylolysis is not preventable. However, it is possible to reduce the risk of fractures, which are the main cause of the symptoms. Avoid traumatic sports and activities that require frequent extension or rotation of the neck. Exercises that strengthen the back and neck muscles can provide additional support.

Most people with spondylolysis have little to no pain and function well after treatment. It is possible to gradually resume sports and other activities without complications. However, it is important to note that the rarity of cervical type means there is a lack of research on its long-term effects. People with spondylolysis, especially of the cervical variety, should receive regular check-ups and keep alert for possible symptoms.