(3) Spondylolisthesis Intro Flashcards
What is the generic term for vertebral slippage?
spondylolisthesis
What line should be used to assess spondylolisthesis?
Georges line
What 4 things must be included in the description of a spondylolisthesis?
L3D
- level
- direction
- degree
- due to
How do you report the level when describing a spondylolisthesis?
- single level, NOT motion segment
- use upper level
What spinal level cannot have a spondylolisthesis?
C1 (no body to define using Georges line)
What are the possible directions of a spondylolisthesis?
- anterolisthesis
- retrolisthesis
- laterolisthesis
Which direction(s) of spondylolisthesis is/are found on a lateral view?
anterolisthesis & retrolisthesis
What is used to report the degree when describing an anterolisthesis?
Meyerding classification (or measurement in mm)
What is used to report the degree when describing an retrolisthesis?
measurement in mm
What is used to report the degree when describing an laterolisthesis?
measurement in mm
Describe the grades of the Meyerding classification system.
- Grade 1= 0-25%
- Grade 2 = 26-50%
- Grade 3 = 51-75%
- Grade 4 = 76-100%
- Grade 5 = >100%
What landmarks are used for Meyerding classification?
Lower segment:
- sup. endplate
- ant. & post. corners
Upper segment:
- post-inf. corner
(*use original contour, not osteophytes)
What radiographic sign is often seen with an L5 anterolisthesis grade 3 or greater, and is also found with hyperlordosis?
Bowline of Brailsford
(L5 vertebral body superimposed on the sacral base on AP view)
What are 2 other names for Bowline of Brailsford?
- Gendarme’s cap
- Inverted Napoleon’s hat
What is another term for a grade 5 anterolisthesis?
spondyloptosis (drooping spine)
What system is used to classify the etiology (due to) when describing a spondylolisthesis?
Wiltse classification
What are the 5 Wiltse classifications?
- dysplastic
- isthmic
- degenerative
- traumatic
- pathologic
What are the 2 most common etiologies of spondylolistheses?
isthmic & degenerative
What should you look at first when determining the etiology of a spondylolisthesis?
posterior elements
Which Wiltse classification is a diagnosis of exclusion?
dysplastic
Which etiology of spondylolisthesis occurs only in the lumbar spine?
isthmic
Which etiology of spondylolisthesis is seen around surgical fusions?
degenerative
What is meant by a dysplastic cause of spondylolisthesis?
congenital or developmental anomaly of the posterior arch
What spinal region do dysplastic spondylolistheses occur more frequently in?
cervical > lumbar
What may cause dysplastic spondylolisthesis in the cervical spine?
congenital absence of articular pillars
What may cause dysplastic spondylolisthesis in the lumbar spine?
elongated or malformed posterior elements
What is the greatest concern for a patient with a spondylolisthesis with a dysplastic cause? What is your next step?
- stenosis & instability
- F/E radiographs
