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Spondylolysis and Spondylolisthesis, Sports Medicine

Bittu Kuruvilla, MD, FAAPMR, CAQSM and Timothy Tiu, MD, FAAPMR, CAQSM Reviewed 04/2019
 


BASICS

DESCRIPTION

  • From Greek, spondylo (vertebra) + lysis (loosening), or listhesis (slippage)

  • Spondylolysis:

    • Involves a defect in the pars interarticularis of the vertebral complex

    • Usually an acquired s...

DIAGNOSIS

  • Classification of spondylolisthesis by direction:

    • Anterolisthesis (most common): forward slippage of superior vertebra over inferior vertebra

    • Retrolisthesis: backward slippage of superior vert...

TREATMENT

GENERAL MEASURES

  • Goal is to return the athlete to pain-free participation in sports along with the prevention of further slippage and spondylolisthesis.

  • Spondylolysis:

    • Cessation of sports for 3...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Monitor symptoms, gait abnormalities, and radiographic progression of spondylolisthesis.

  • In the skeletally immature, monitoring is more important because changes a...

REFERENCES

1
Gagnet P, Kern K, Andrews K, et al. Spondylolysis and spondylolisthesis: a review of the literature. J Orthop.  2018;15(2):404–407.
2
Leone A, Cianfoni A, Cerase A, et al. Lumbar spondy...

CLINICAL PEARLS

  • Initial imaging for suspected spondylolysis or spondylolisthesis, in the absence of neurologic abnormalities, should be x-ray with AP and lateral views.

  • SPECT scan is the most sensitive...

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