Spondylolisthesis Flashcards
What is spondylolisthesis?
An anterior subluxation of one vertebra on another, most commonly between L5 and S1
What are the 5 types of spondylolisthesis?
Type I - Dysplastic
Type II - Isthmic
Type III - Degenerative
Type IV - Traumatic
Type V - Pathologic
What is an example of a type I, dysplastic cause of spondylolisthesis?
Spina bifida occulata
What is an example of a type II, isthmic cause of spondylolisthesis?
Pars interarticularis defect or injury
What is an example of a type III, degenerative cause of spondylolisthesis?
General wear and tear
What is an example of a type IV, traumatic cause of spondylolisthesis?
Injuries other than a pars injury
What is an example of a type V, pathologic cause of spondylolisthesis?
Tumours, bone disease
What is the pars interarticularis?
This is a region between 2 facet joints, lying between the superior and inferior articular processes
How is the severity of spondylolisthesis graded?
Meyerding grading, which is graded upon the percentage of spondylolisthesis
How is the percentage of spondylolisthesis calculated?
Distance of the slip, divided by the AP diameter of the vertebral body above, multiplied by 100
What are the 5 grades of the Meyerding grading?
<25% ⇒ Grade I
25-50% ⇒ Grade II
50-75% ⇒ Grade III
75-100% ⇒ Grave IV
> 100% ⇒ Spondyloptosis
How will spondylolisthesis present?
Patients with a spondylolisthesis will often have problems with walking and significant leg symptoms due to pain spreading from the lower back to the thighs
There will also be symptoms of the underlying pathology
How is spondylolisthesis managed
Management usually depends on the underlying pathology and symptoms
In cases of isthmic and degenerative spondylolisthesis, decompression and fusion is preferred
