Bilateral Spondylolysis Of L5 With Grade 1 Spondylolisthesis

Lumbar kyphosis is 20º.

Bilateral spondylolysis of l5 with grade 1 spondylolisthesis. The facet joint is no longer able to hold the vertebra in place against the ever present downward force of body weight. Because the l5 vertebra had slipped forward between 26 50 over the s1 vertebra beneath it dr. 60 80 of people with spondylolysis have associated spondylolisthesis. The most common type of isthmic spondylolisthesis is l5 s1 spondylolysis which is when the lowest lumbar vertebra slides onto the sacrum.

Frazier classified the patient s condition as a grade 2 on the wiltse scale. Note that the degree of spondylolisthesis can progress over time. Spondylolysis is a crack or stress fracture in one of the vertebrae the small bones that make up the spinal column. With the condition of spondylolisthesis the pars interarticularis defect can be on one side of the spine only unilateral or both sides bilateral.

Slippage is measured on a scale from grade 1 slippage 25 to grade 4 100. Diffuse mild to moderate degenerative disk disease of the lumbar spine most severe at l5 s1 is seen. There is a gap of about 3 mm in the pars defects themselves. Image courtesy of gerard j.

Pre op flexion and. The patient had a slipped vertebra also known as spondylolisthesis at l5. Chronic defect of the bilateral pars of l5 with grade 1 spondylolisthesis 9 7 to 10 mm is identified. There is also a grade i spondylolisthesis at l4 l5.

There is very subtle grade 1 anterior spondylolisthesis measuring just a few millimeters on x ray and ct. Spondylolysis spon dee low lye sis and spondylolisthesis spon dee low lis thee sis are common causes of low back pain in young athletes. The most common level it is found is at l5 s1 although spondylolisthesis can occur at l4 l5 and rarely at a higher level. From june 2005 to the end of 2011 i have tried multiple sessions of physical therapy and other forms of treatment.

Bilateral l5 spondylolytic pars defects. 1 2 90 of cases of spondylolysis and spondylolisthesis affect l5 and most of the remainder affect l4. Spondylolisthesis is the forward slippage of a vertebra out of its normal position caused by a pars fracture. However instances of spondylolysis l5 l4 also occur.

Image courtesy of gerard j. These fractures are not healed and at this point they are not expected to heal. Isthmic spondylolisthesis affects around 5 of the population but is more common in young athletes.