Spondylolisthesis

Question 1

Define spondylolisthesis

Answer 1

Anterior slipping of a vertebral body

Question 2

Define spondylosis (osis)

Answer 2

Degenerative disc disease resulting in disc space narrowing and osteophyte growth

Question 3

Define spondylolysis (lysis)

Answer 3

Fracture of the pars interarticularis

Unilateral or bilateral

Question 4

What does a Scotty dog with a collar indicated on an X-ray?

Answer 4

Pars interarticularis fracture

Question 5

Most common cause of spondylolysis

Answer 5

Repetitive micro trauma

Question 6

Define RPO in terms of xray

Answer 6

Right posterior quadrant against cassette

Question 7

What cervical IVF is lined up in an RPO radiograph?

Answer 7

Left IVF (space)

Question 8

In lumbar, which pars is in line with RPO radiograph

Answer 8

Right pars (structure in profile)

Question 9

True or false: pars defects are just one of several causes of spondylolisthesis

Answer 9

True

Question 10

What is another term for spondylolisthesis?

Answer 10

Anterolisthesis

Question 11

What is the most common cause of a spondylolisthesis?

Answer 11

Pars fracture

Question 12

What is referred to by ‘spondy’?

Answer 12

Spondylolisthesis

Question 13

What is the classification system for the types of spondylolisthesis?

Answer 13

Newman or Wiltse Classification System

Essentials of skeletal radiology

Question 14

Describe type 1 spondylolisthesis

Answer 14

Congenital or dysplastic

Question 15

Describe type 2 spondylolisthesis

Answer 15

Lytic Spondylolisthesis
*pars fracture
Three subtypes (abc)

Question 16

What are the three subtypes of type 2 spondylolisthesis?

Answer 16

Type a - stress fracture
Type b - (healed fracture) elongated pars
Type c - acute fracture

Question 17

What is the most common subtype of type 2 spondylolisthesis?

Answer 17

Type a - stress fracture in pars fracture

Question 18

Where is the most common type 2 spondylolisthesis subtype a?

Answer 18

L5

Question 19

How likely is a type 2 spondylolisthesis subtype a to heal?

Answer 19

Very unlikely

Question 20

How do you determine potential to heal a type 2 spondylolisthesis subtype a on a young child?

Answer 20

MRI - brightness in area indicates physiological activity - potential for healing

Question 21

Describe type 3 spondylolisthesis

Answer 21

Degenerative

• no fractures
• facet degeneration

Question 22

Where do most type 3 spondylolisthesis occur?

Answer 22

L4

Question 23

Describe type 4 spondylolisthesis

Answer 23

Traumatic - fracture anywhere in the arch EXCEPT pars

Question 24

Describe type 5 spondylolisthesis

Answer 24

Pathologic

• bone tumor
• contributing to pars fracture

Question 25

Describe type 6 spondylolisthesis

Answer 25

Iatrogenic (Healer - iatro) - because of laminaectomy

Question 26

What is the grading system used for spondylolisthesis?

Answer 26

Meyerding Classification System

Question 27

Describe how the grading of a spondylolisthesis is done

Answer 27

Comparing endplate of level below slipped VB and posteroinferior corner of slipped VB

Question 28

Explain grade 1-4 spondylolisthesis

Answer 28

``` Grade 1 = 0-25% Grade 2 = 25%-50% Grade 3 = 50%-75% Grade 4 = 75%-100% High and low qualifiers ```

Question 29

What is Ulman’s line

Answer 29

Drawing perpendicular line from segment below potential spondylolisthesis

Question 30

What line can you draw to help determine whether or not a spondylolisthesis is present?

Answer 30

Ulman’s line