Spondylolysis and spondylolisthesis introduction There is always confusion in the medical community in regards to spondylolysis and spondylolisthesis, although it is very likely to be seen in the adolescent athlete...
Spondylolysis and spondylolisthesis introduction There is always confusion in the medical community in regards to spondylolysis and spondylolisthesis, although it is very likely to be seen in the adolescent athlete population. Spondylolysis is an anatomical defect or fracture of the pars interarticularis of the vertebral arch. The pars interarticularis is an isthmus of bone connecting the superior and inferior facet surfaces in the spine at a given level.
The defects can occur unilaterally or bilaterally. Spondylolysis is one of the most common causes of lower back pain in adolescents, although it remains asymptomatic in the majority of patients. Spondylolysis can progress to spondylolisthesis, which is defined as anterior displacement of the vertebral body in reference to the bordering vertebral bodies.
Case Vignette A 15 year old male football lineman presents to your clinic with insidious onset low back back that has been ongoing for about 3 months. He recently began increasing his off-season activity drills as both an offensive and defensive lineman and his symptoms seem to be worse when pass blocking. He denies any numbness of tingling radiating down his legs.
On examination, he has increased lumbar lordosis and tightness in his biceps femoris muscles. He has an equivocal single-leg hyperextension test. He has a negative straight leg and slump test.
His lower extremity strength is 5/5 throughout. What is the most appropriate imaging modality? Type I is dysplastic and refers to a congenital dysplasia that results in the anterior and superior rounding of the S1 vertebrae.
If you are experiencing symptoms that may be related to spondylolyisis and spondylolisthesis, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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