Spondylolysis is the degeneration or deficient development of the articulating part of the vertebrae. It occurs in 6% of the general population and occurs only in persons who are able to stand upright and walk, which is thought to be a causative factor. The condition is virtually nonexistent among newborns, but exists in 5% of 6 year olds. Spondylolysis is more common in persons who participate is sports such as diving, weight lifting, wrestling and gymnastics - activities that require repetitive hyperextension.
In combination with other factors, spondylolysis may permit forward slippage of one vertebra on the one below, producing a spondylolisthesis. This occurs most commonly at the last lumbar vertebra (L5) causing it to slip on the first sacral vertebra (S1).
Many young persons with spondylolysis and spondylolisthesis may have no symptoms. Persons often develop symptoms during the preadolescent growth spurt. Magnitude of symptoms does not always correlate with the severity of slip.
Many persons require no treatment for the condition. Persons with spondylolysis or low-grade spondylolisthesis may be managed conservatively without surgery. Skeletally immature persons with slippage greater that 30-50% are at increased risk for progression and are considered candidates for spinal fusion without delay.
This MediFocus Guide contains an extensive listing of citations and abstracts of recent journal articles that have been published about this condition in trustworthy medical journals. This is the same type of information that is available to physicians and other health care professionals. A partial selection of journal articles that are abstracted in this MediFocus Guide includes:
Iatrogenic spondylolysis leading to contralateral pedicular stress fracture and unstable spondylolisthesis: a case report. Spine. 2000
Management of spondylolysis and spondylolisthesis in the pediatric and adolescent population. Orthopedic Clinics of North America. 1999
Management of degenerative disc disease above an L5-S1 segment requiring arthrodesis. Spine. 1999
Spondylolisthesis in children. Cause, natural history, and management. Spine. 1999
Conditions of the spine. Adolescent Medicine. 1998
Complications in spinal fusion. Orthopedic Clinics of North America. 1998
The role of surgery in the management of low back pain. Baillieres Clinical Rheumatology. 1998
Is there increased intervertebral mobility in isthmic adult spondylolisthesis? A matched comparative study using roentgen stereophotogrammetry. Spine. 2000
Traumatic spondylolisthesis of the axis: treatment rationale based on the stability of the different fracture types. European Spine Journal. 2000
Sagittal plane configuration of the sacrum in spondylolisthesis. Spine. 2000
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