Pediatric Pars Fractures

According to the American Academy of Physical Medicine and Rehabilitation, pediatric pars fractures occur in children involved in “repetitive bending and straightening of the spine.  They are generally self-limited and get better with rest followed by rehabilitation.”  Pars fractures, also called lumbar spondylolysis, can affect 30% of adolescents, especially if they are involved in sports.

What does pediatric pars fractures really mean?  ‘Pediatric’ means child, this branch of medicine heals children up to 18 years old.  ’Pars’ refers to the part of the spine involved, also known as pars interarticularis.  A ‘fracture’ can be a tiny crack in a bone that is caused by stress or force.

A child or teenager may get pars fractures due to overloading the muscles of the spine.  The fractures are most common with kids who are athletic.  Sports such as gymnastics, weight lifting, wrestling, rowing, diving, figure skating, dancing, soccer, tennis, volleyball and football have all been found to cause these pediatric pars fractures.  The reasons being that each sport puts pressure on the back, or requires much strength from the back.  If the young athlete does not properly stretch after every excursion, a fracture can occur.

The most common symptom is pain in the lower back.  For pars fractures, the pars interarticular is found in the posterior portion of the spine.  If the pars cracks, pain will occur.  The best way to diagnose pediatric pars fractures would be a spinal X-ray, though a CT scan or MRI may be needed to see if there is any nerve damage.

The earlier the fracture is diagnosed, the better.  The best way to heal a bone fracture is simply to rest.  No participating in a sport for at least a month.  From there, the patient should undergo several sessions of physical therapy to improve the strength of the back.  The use of pain medication should be watched carefully.  According to Dr. Sally Harris of the Palo Alto Medical Foundation, drugs like ibuprofen (Advil) and naproxen (Aleve) have been shown to slow bone healing.  However, Tylenol or Acetoaminophen, can be used for pain and doesn’t affect how bones heal.  Most adolescent athletes have found that they can’t fully return to their sport until they have had about 3 months to heal.

Like with most conditions, catching a pediatric pars fracture early is critical.  With proper rest and healing, the adolescent can return to their normal activity level after just a few months.  And catching the fracture early also helps to make sure that the condition won’t get worse before it can be properly treated.