I was involved in a car accident that has gone into litigation. One of the problems is that I ended up with a condition called cervical spondylolysis. There is some question about whether I had this before the accident or if it developed as a result of the trauma. How does this condition usually develop?

In the cervical spine, spondylolysis describes a cleft or place where the bone doesn’t meet in the middle. The area affected most often is where the upper or superior facet (spinal) joint meets the lower or inferior facet joint. When present on both sides of the vertebra, this defect results in a forward migration or movement of the superior (upper) vertebra.

Most people with a cervical spondylolysis defect don’t even know they have it until trauma occurs and they develop symptoms. Trauma-induced injury can either make the problem worse or just bring it to the attention of the physician when X-rays are taken and the lesion is observed at that time. They call this unexpected discovery an incidental finding.

The spondylolytic defect is clearly visible on X-rays. MRIs may or may not show changes in signal intensity indicating a force is being exerted against the spinal cord. Even though MRIs don’t show cord compression, the symptoms can be severe enough to schedule surgery to stabilize and fuse the spine.

What causes cervical spondylolysis? There is some evidence by the way the structures look that some people might be born with this problem. In some cases, the pedicle (supporting column of bone) is missing, so it’s clear that there’s a genetic defect. In other people with this problem, repetitive microtrauma might be the reason stress fractures occurred causing the bones to separate and form a cleft.