Spondylolysis & Spondylolysthesis Flashcards
What is Spondylolisthesis and what is it’s significance?
is a forward or backward slippage of one vertebra on an adjacent vertebra.
Can lead to:
narrowing of the spinal canal (central spinal stenosis)
compression of the exiting nerve roots (foraminal stenosis).
What causes Spondylolisthesis?
Trauma
Degenerative
Tumours
Birth defects (congenital)
Where is Spondylolisthesis commonly located?
at L5/S1 and to a lesser degree L4/5.
Describe the 5 major types of Spondylolisthesis
Dysplastic: a congenital defect in the formation of the facet, enabling the vertebra to slip forward uninhibited.
Isthmic: defect in a portion of the vertebra called the pars interarticularis. Caused by repetitive trauma/ hyperextension e.g.. gymnasts.
Degenerative: occurs due to arthritic changes in the joints of the vertebrae from cartilage degeneration (common in elderly patients)
Traumatic: from direct trauma or injury to the vertebrae e.g.. fracture of the pedicle, lamina or facet joints
Pathologic: a defect in the bone caused by abnormal bone e.g.. tumour
What are some common symptoms of Spondylolisthesis?
Step deformity
LBP (worse after exercise particularly if it involves extension of the lumbar spine) and decreased ROM
Tight hamstrings
Paraesthesia in the legs due to nerve compression
(potentially causing loss of control of bowel or bladder function, or cauda equina syndrome).
What would be the best image to diagnose this condition?
. A lateral X-ray will show the position of one vertebra relative to another- and whether it has slipped forward.
How is this condition graded?
Meyerding classification:
Grade I is a slip of up to 25%
Grade II is between 26%-50%
Grade III is between 51%-75%
Grade IV is between 76% and 99%
Grade V, 100% or spondyloptosis occurs when the vertebra has completely fallen off the next vertebra.
How would osteopaths treat this condition?
Help to increase range of motion of the lumbar spine and hamstrings as well as strengthen the core abdominal muscles.
