Info

Spondylolytic Spondylolisthesis

Degenerative Spondylolisthesis

Age

Young

Middle aged

Level

Predominantly at L5-S1

Common at L4-L5

Gender

More common in males

More common in females

Slip progression

Common

Limited, up to 30%

Imaging Studies

Plain lateral films usually show degenerative disc disease and vertebral slip at L4-L5. It is not uncommon to find anterior or posterior slippage in vertebrae above L4. No pars defects are seen (Figure 510). Facet arthropathy and vacuum phenomenon are frequently found. Traction spurs are present at the L4 or L5 vertebral bodies. Unlike osteoarthritic spurs, which emanate from the vertebral body corner, traction spurs originate 1-2 mm away from the vertebral corner, at the attachment point of the anterior longitudinal ligament. Traction spurs are usually parallel to the vertebral endplate (Figures 5-11A and 5-11B).

Lateral flexion and extension views help determine the degree of instability. Frequently, they show increased forward slippage and vertebral body tilt during flexion. Both, the slip and vertebral tilt are frequently reduced during extension (Figures 5-12A and 5-12B).

CT and MR images will clearly demonstrate the degenerative changes, the vertebral slip, and the intact pars (Figure 5-13).

Management

No specific treatment is presently available for degenerative disc disease. Analgesic medications and anti-inflammatory drugs usually

Traction Spur

Traction Spur

Traction Spur Elbow
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