Skip to Main Content

We have a new app!

Take the Access library with you wherever you go—easy access to books, videos, images, podcasts, personalized features, and more.

Download the Access App here: iOS and Android. Learn more here!

  • Cervical spondylolysis

  • 738.4 Acquired spondylolisthesis

  • M43.00 Spondylolysis, site unspecified


  • Stress fracture of the pedicles on the vertebra below
  • Tightness or pain in the neck region
  • Often no symptoms
  • Weakness in the pars

Essentials of Diagnosis

  • Diagnosis made by X-ray
  • Can be acquired or congenital
  • Neck pain

General Considerations

  • Instability
  • Avoid extension positions that increase symptoms
  • Thin vertebral bone: pars


  • Teenagers with high risk activities are more at risk
  • Runs in families

Signs and Symptoms

  • Pain in cervical spine, shoulder, arm, upper extremity
  • Stiffness along spine
  • Headaches
  • Pain in cervical spine worsens with extension

Functional Implications

  • Difficulty sustaining standing postures secondary to neck and arm pain
  • Inability to sleep flat on the back without a pillow
  • Difficulty with movements (reaching overhead) secondary to pain
  • Limit sports participation

Possible Contributing Causes

  • Forceful extension from hit under the chin (sports)
  • Congenital
  • Car accident, hit from rear
  • Hyperextension of the cervical spine
  • Increased cervical lordosis posture

Differential Diagnosis

  • Peripheral nerve impairment
  • Spinal tumor
  • Peripheral neuropathy
  • Paraspinal spasms
  • Degenerative disk disease
  • Stenosis


  • MRI helps to visualize compressed or inflamed nerve root in diagnosis
  • X-ray/plain-film radiograph to see vertebra position
  • CT scan to show herniation compressing the spinal canal/nerves
  • Electrodiagnostic/nerve conduction testing can help to determine a specific impaired nerve function

  • Stress fracture of the pars

  • Restricted mobility of the upper cervical spine
  • Hypermobility
  • Weakness noted of neck musculature

  • Rest
  • Bracing
  • Address Pain
    • Electrical stimulation
    • Heat/ice
  • Address hypertonicity
    • Soft-tissue massage
    • Heat
  • Address muscle weakness
    • Stability exercises

  • Patient will be able to
    • Sit with neutral cervical spine posture for greater than 30 minutes with 0 out of 10 pain rating
    • Stand at work station and perform computer work for 45 minutes with 0 out of 10 pain rating
    • Rotate cervical spine 75 degrees so as to look over the shoulder while driving the car with 0 out of 10 pain rating

  • Fair to good depending on severity of vertebral translation, amount of nerve-root compression, and upper/lower-extremity impairments

1. The American Physical Therapy Association. Pattern 4E: Impaired Joint Mobility, Motor Function, Muscle Performance, and Range of Motion Associated With Localized Inflammation. Interactive Guide to Physical Therapist Practice 2003. ...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.