Spondylolysis

Question 1

Spondylolysis m/c at what vertebral level

Answer 1

L5

Question 2

T/F: spondylolisthesis is more common in females

Answer 2

TRUE

Question 3

Male:Female spondylolysis

Answer 3

Males over females by a ratio of

2-3 : 1

Question 4

T/F: patient has a spondylolysis it

does not exclude other causes of pain

Answer 4

TRUE

Question 5

gold stand for diagnosing a spondylolysis

Answer 5

MR

better than a SPECT

Question 6

occurs while the
patient is skeletally immature
• More common to progress in females
• Risk of progression is between 3-28%

Answer 6

Progression of a spondylolisthesis

Question 7

if the sacral base is more “_____,” the

chances of spondylolisthesis progression increase

Answer 7

vertical

Question 8

• Spinal canal and neural foraminal narrowing

* Secondary to multifactorial degenerative changes

Answer 8

Acquired Spinal Stenosis

Question 9

The four ‘F’s’ of a degenerative spondylolisthesis

Answer 9

̔ Female
̔ Four (L4)
̔ Forty (above 40 yoa)
̔ Fat

Question 10

Stenosis C/S =

Answer 10

<13

sagittal central canal

Question 11

Stenosis L/S =

Answer 11

<10-12

sagittal central canal

Question 12

best way to visualize spinal stenosis

Answer 12

axial plane, direct visualization of cord and/or nerve root
compression
MR/CT

Question 13

the posterior aspect of the trefoil (or the cause of posterolateral narrowing) is due to a

Answer 13

combination of facet arthrosis and ligamentum flavum hypertrophy

Question 14

Creates an extra-dural mass extending from the
facet into either the spinal canal, lateral recess,
neural foramen, or extraforaminal space

Answer 14

Ganglion cyst of the facet joint formed in a degenerated facet joint

Question 15

what image is gold standard for facet cyst

Answer 15

MR
bright on T2
dark on T1

Question 16

tx of facet cyst

Answer 16

• Surgery – e.g., laminectomy with cyst excision,
percutaneous cyst aspiration
• Conservative care – e.g., chiropractic, rest, analgesics

Question 17

Spondylolisthesis: ALWAYS described and graded in relationship to
the vertebral body _____ to it

Answer 17

inferior

Question 18

Spondylolisthesis

Anterior translation

Answer 18

anterolisthesis

Question 19

Spondylolisthesis

Posterior translation

Answer 19

retrolisthesis

Question 20

Spondylolisthesis

Lateral translation

Answer 20

laterolisthesis

Question 21

Spondylolisthesis

Complete loss of an articular relationship between two vertebral segments, always anterior

Answer 21

spondyloptosis

Question 22

due to congenital anomaly of the
upper sacrum or L5 neural arch, leading to
displacement

Answer 22

type I (dysplastic)

Question 23

Classification method of spondylolisthesis

Answer 23

Wiltse classification

Question 24

due to spondylolysis; 3 subtypes
̔ A. a stress (fatigue) fracture of the partes interarticularii
̔B. an elongated, but intact, partes interarticularii
̔C. an acute fracture of the partes interarticularii (rare)

Answer 24

Type II (isthmic)

Question 25

aka pseudospondylolisthesis;
due to long-standing degenerative disease of the facet and discovertebral joints with no separation of the partes interarticularii

Answer 25

Type III (degenerative)

Question 26

due to a fracture of the neural

arch in any place except the partes interarticularii

Answer 26

Type IV (traumatic)

Question 27

due to generalized bone disease

e.g., Paget’s, mets

Answer 27

Type V (pathologic)

Question 28

best imaging for spondylolisthesis

Answer 28

plain film x ray

Question 29

1 – <25% displacement

Answer 29

I

Question 30

25 – 50% displacement

Answer 30

II

Question 31

50 – 75% displacement

Answer 31

III

Question 32

75 – 100% displacement

Answer 32

IV

Question 33

> 100% (spondyloptosis)

Answer 33

V