Spondylolysis/Spondylolisthesis Flashcards
What is spondylolysis?
Pars interarticularis defect
What is spondylolisthesis?
Forward translation of one vertebra to another
What is Type I spondylolysis/spondylolisthesis?
Congenital spondylolisthesis
- Dysplastic sacral facet joints
What is Type II spondylolysis/spondylolisthesis?
Isthmic spondylolisthesis
- Pars interarticularis stress fracture
What is Type III spondylolysis/spondylolisthesis?
Degenerative spondylolisthesis
- Facet arthropathy
What is Type IV spondylolysis/spondylolisthesis?
Traumatic
- Trauma to the facet or pars
What is Type V spondylolysis/spondylolisthesis?
Pathologic process
What is the grading of spondylolysis/spondylolisthesis?
Grading (based on translation) Grade 1: 1-25% Grade 2: 26-50% Grade 3: 51-75% Grade 4: 76-100%
What people are most common to have spondylolysis/spondylolisthesis?
***Repetitive hyperextension
- Gymnasts
- Football linemen
What locations are commonly associated with isthmic?
82 % L5-S1
11% L4-L5
What location is commonly associated with a degenerative condition?
L4-L5
What is important to remember about the relationship between spondylolysis and spondylolisthesis?
50% of spondylolysis are not associated with spondylolisthesis
What are the s/s of spondylolysis/spondylolisthesis?
Back pain with movement
Radiculopathy
- Can mimic spinal stenosis
What is observed in PE of spondylolysis/spondylolisthesis?
- Look at curvature, loss of lordosis, spinous process step-off
Motor and sensory exam
- +/- decreased DTRs
- Motor exam is usually normal
- Decreased strength testing after walking
- SLR (isthmic- d/t hamstring spasms)
What is the treatment of spondylolysis/spondylolisthesis?
Conservative
- Including weight loss
Surgical
- Skeletally immature
- Stabilization of the defect
