- Spondylolisthesis refers to slipping of part or all of one vertebra forward on another.
- Usually associates with bilateral pars defects
- Most common in children (9-14yr of age)
- Familial predisposition. Athletes overuse injury (stress fracture) rarely progress to Spondylolisthesis
- Usually L5 slips forward on S1
Staging
- Grade 1 (<25% slip)
- Grade 2 (25 - 50% slip)
- Grade 3 (50 - 75% slip)
- Grade 4 (>75% slip)
Diagnosis
- Present with low back pain +/_ lower leg pain
- A gap may be palpable on examination
- Lateral Xray show the slip
Management for Grade 1 and 2 slip
- Symptomatic approach
- Rest from aggravating factors
- Strengthening of abdominal and extensor + stretching Hamstring
- Manipulation and mobilisation of stiff joints above and below (should not manipulate at the level of slip)
- Can return to sports when pain free on lumber extension and
Management for grade 3 and 4 slip
- Symptomatic management
- Should avoid contact sports and high speed sports
- If slip progress, can consider Spinal Fusion