Spondylolysis, Spondylolisthesis

Spondylolisthesis is defined as the forward displacement of one vertebral body over the subjacent one, and the term spondylolysis encompasses a spectrum of pathologies at the pars articularis that ranges from bone stress cancellous edema in the MRI to pars fractures that ultimately predispose the vertebra to displace forward. Most pars defects develop during early childhood without clinically manifestations. It typically occurs more often in adolescent athletes than in the general population, and some specific sports predispose to it. Spondylolysis is usually asymptomatic, and when the patients present symptoms, they typically complain of low back pain that generally gets worse with back extension. The risk of progression of a spondylolisthesis after the age of 20 years is less common compared to progression during childhood and adolescence. The vast majority of patients recover from pain without surgical intervention. For the few young sporting individuals that don’t recover or experience disabling symptoms, surgery may be required. Spondylolisthesis may present with symptoms of compressive radiculopathy like shooting pain, numbness, tingling, or weakness in the lower extremities. Symptomatic high-grade dysplastic spondylolisthesis in children is prone to surgical treatment, and many different techniques have been described as being the authors’ preference as the posterior approach for the treatment of the sagittal plane.