Scoliosis

Question 1

Define SpondyloLYSIS

Answer 1

Is a break (Fracture) which is located somewhere in the posterior arch of the vertebra. Typically in the pars interarticularis.

Question 2

What can happen if a break in the vertebra occurs?

Answer 2

The stability of that vertebra may be compromised.

Question 3

Micro or macro motion at the fracture site may…?

Answer 3

1. Become a generator of chronic LBP
2. Result in an actual anteriolisthesis (slip)
3. Worsen a pre-existing slip!
4. May also be completely asymptomatic

Question 4

What is the best type of imaging to see spondylolysis?

Answer 4

Mid-body cut CT (highest specificity)

Question 5

Where is the pars interarticularis located?

Answer 5

Between the superior and inferior articular processes. (Between SAP and IAP)

Question 6

What’s the most common form of spondylolisthesis instability?

Answer 6

Sagittal A-P Translational instability (AKA Sagittal rotational instability)

Question 7

What’s the measurement between the flexion and extension x-rays that constitute it as a slip?

Answer 7

> 3.5 mm! (AMA Guides-5th) ** gold standard

Flexion-Extension

Question 8

What’s a type of instability that is a relatively uncommon finding?

Answer 8

Sagittal angular motion instability

Question 9

What type of fracture is a spondylolysis classified as?

Answer 9

An Acquired stress fracture

Question 10

What age does Spondylolysis majority occur?

Answer 10

First decade of life (10-20 years possible)

Question 11

What is Reactive Sclerosis?

Answer 11

A unilateral spondylolysis alters the biomechanics, causing the forces to be rerouted to the contralateral pars