Spondylolysis Flashcards
Spondylolysis m/c at what vertebral level
L5
T/F: spondylolisthesis is more common in females
TRUE
Male:Female spondylolysis
Males over females by a ratio of
2-3 : 1
T/F: patient has a spondylolysis it
does not exclude other causes of pain
TRUE
gold stand for diagnosing a spondylolysis
MR
better than a SPECT
occurs while the
patient is skeletally immature
• More common to progress in females
• Risk of progression is between 3-28%
Progression of a spondylolisthesis
if the sacral base is more “_____,” the
chances of spondylolisthesis progression increase
vertical
- Spinal canal and neural foraminal narrowing
* Secondary to multifactorial degenerative changes
Acquired Spinal Stenosis
The four ‘F’s’ of a degenerative spondylolisthesis
̔ Female
̔ Four (L4)
̔ Forty (above 40 yoa)
̔ Fat
Stenosis C/S =
<13
sagittal central canal
Stenosis L/S =
<10-12
sagittal central canal
best way to visualize spinal stenosis
axial plane, direct visualization of cord and/or nerve root
compression
MR/CT
the posterior aspect of the trefoil (or the cause of posterolateral narrowing) is due to a
combination of facet arthrosis and ligamentum flavum hypertrophy
Creates an extra-dural mass extending from the
facet into either the spinal canal, lateral recess,
neural foramen, or extraforaminal space
Ganglion cyst of the facet joint formed in a degenerated facet joint
what image is gold standard for facet cyst
MR
bright on T2
dark on T1
tx of facet cyst
• Surgery – e.g., laminectomy with cyst excision,
percutaneous cyst aspiration
• Conservative care – e.g., chiropractic, rest, analgesics
Spondylolisthesis: ALWAYS described and graded in relationship to
the vertebral body _____ to it
inferior
Spondylolisthesis
Anterior translation
anterolisthesis
Spondylolisthesis
Posterior translation
retrolisthesis
Spondylolisthesis
Lateral translation
laterolisthesis
Spondylolisthesis
Complete loss of an articular relationship between two vertebral segments, always anterior
spondyloptosis
due to congenital anomaly of the
upper sacrum or L5 neural arch, leading to
displacement
type I (dysplastic)
Classification method of spondylolisthesis
Wiltse classification
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)
Type II (isthmic)
