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SpondylolisthesisAka: Degenerative Spondylolisthesis, Isthmic Spondylolisthesis, Spondyloptosis

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  1. See Also
    1. Back Pain
  2. Definition
    1. Slippage of fifth lumbar vertebrae on s1
  3. Types
    1. Degenerative Spondylolisthesis (adults)
      1. More common in women over age 40
    2. Isthmic Spondylolisthesis (children)
      1. Secondary to Spondylolysis
      2. More common in athletes (gymnastics, football)
  4. Symptoms
    1. Back pain radiates posteriorly into knees
    2. Hamstring spasms with inability to bend forward
    3. Limited Straight Leg Raise
    4. Bending, lifting or twisting provokes pain
  5. Signs
    1. Loss of lumbar lordosis
    2. Flattening of buttocks
    3. Step-off at the affected spinous process (usually L5)
    4. Hamstring spasm
      1. Limited forward flexion
      2. Difficult Straight Leg Raise
  6. Radiology: Lateral Lumbosacral Spine XRay
    1. Position of posterior-inferior corner of L5
      1. Grading anterior slippage based on position over S1
  7. . Sacral base (top of S1) is divided into 4 sections
      1. Grade 1 <26% slippage (posterior)
      2. Grade 2 26-50% slippage
      3. Grade 3 51-75% slippage
      4. Grade 4 75-100% slippage (anterior)
      5. Grade 5 >100% slippage (spondyloptosis)
  8. Monitoring
    1. Adolescents
      1. Repeat XRay until full adult height reached q6 months
  9. Management
    1. Avoid provocative activities (e.g. hyperextension)
    2. Analgesics for pain
    3. Consider bracing
    4. Physical therapy
  10. Orthopedic or spine surgeon referral indications
    1. High grade slippage >50%
    2. Failed medical management
  11. References
    1. Greene (2001) Musculoskeletal Care, p. 573-6
    2. Humphreys (2002) Am Fam Physician 65(11):2299

Spondylolisthesis (C0038016)

Definition (MSH)Forward displacement of one vertebra over another.
ConceptsDisease or Syndrome (T047)
MSHD013168
EnglishSPL - Spondylolisthesis, Spondylistheses, Spondylisthesis, Spondylolistheses, Spondylolisthesis, Spondylolithesis
Spanishespondilolistesis
Parent ConceptsSpinal Diseases (C0037933), Non-Neoplastic Bone Disorder (C1334997), Spinal instability (C0410648)
SourcesCOSTAR, DXP, LCH, MSH, MTH, NCI, NDFRT, OMIM, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)


Degenerative spondylolisthesis (C0264184)

ConceptsDisease or Syndrome (T047)
ICD9738.4
EnglishDegenerative spondylolisthesis
Spanishespondilolistesis degenerativa
Parent ConceptsAcquired spondylolysis (C0158513), Acquired musculoskeletal deformity (C0264132), Acquired deformity of spine NOS (C0264179), Degenerative disorder (C1285162), Duplicate concept (C1274013)
SourcesMTHICD9, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)


Isthmic spondylolisthesis (C0410656)

ConceptsDisease or Syndrome (T047)
EnglishIsthmic spondylolisthesis
Spanishespondilolistesis istmica
Parent ConceptsAcquired spondylolysis (C0158513)
SourcesSCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)


[Q] Spondyloptosis (C0410658)

ConceptsDisease or Syndrome (T047)
EnglishSpondyloptosis
Spanishespondiloptosis
Parent ConceptsAcquired spondylolysis (C0158513), [Q] Vertebral column qualifying terms (C0476185)
SourcesSCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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