Our 14-year-old daughter was just diagnosed with spondylolysis. She’s been told by the orthopedic surgeon to reduce her activity level until the symptoms go away. How long will this take?

Spondylolysis is a stress fracture of the spine. In particular, the pars interarticularis has a fracture line. The pars is located on the posterior portion of the vertebral bone.

With spondylolysis, the fracture is undisplaced. In other words, the bone still lines up on either side of the fracture. The lumbar spine is affected most often, especially at the L4 or L5 level.

Treatment is conservative at first. Rest and reduction of activity levels are advised until the pain goes away. This time period varies from patient to patient. It depends (in part) on how well the child follows the doctor’s recommendations.

If the symptoms are not improved, then a back brace may be ordered. The brace helps decrease muscle spasms and stabilizes the spine. It usually takes six to eight weeks for bone to heal in this age group. Once the symptoms have resolved, then a physical therapy program is often started.

Strengthening of the abdominal, trunk, and back muscles is needed to prevent this problem from recurring. From start to finish, expect at least 10 to 12 weeks from the time of diagnosis until normal resumption of activities. If a back brace is prescribed, it must be worn a minimum of three months before rehab begins. It may take another six months to gradually wean from wearing the brace. In a small number of cases, surgery may be needed.