Pars Defect Listhesis

If a patient has significant leg pain, weakness, and/or numbness, electromyography and nerve conduction velocity (EMG/NCV) tests may be recommended.

There are a number of causes of spondylolisthesis, and a classification system was developed by Wiltse.

There are six types (or causes): Type I is congenital (birth defect) or dysplastic (developed abnormally early in life), Type II is isthmic (caused by a pars fracture and instability), Type III is degenerative (caused by arthritis), Type IV is traumatic (acute facet fracture/injury to the facet complex), Type V is pathologic (caused by a tumor, cancer, or infection), and Type IV is postsurgical (iatrogenic bone removal).

The neurological examination of strength, sensation, and reflexes is usually always normal in children.

Adults with spondylolysis and/or spondylolisthesis frequently have lumber tenderness and an antalgic gait (pain causing abnormal walking), but rarely have a noticeable deformity unless the slippage is severe or has been present since childhood.

A discogram may useful in an adult patient to determine if the discs adjacent to the spondylolysis/spondylolisthesis are also causing pain.

A doctor performs this procedure by injecting radiopaque dye, under pressure, into the discs of the lumbar spine.

A bone scan may be ordered to determine if the spondylolysis pars fracture is recent (acute), or if it is old (chronic).

A recent fracture would generally have a significant radionucleotide uptake and appear as a "hot spot" in the lower lumbar region.

There are no laboratory tests used to diagnose spondylolysis or spondylolisthesis.

Occasionally, specific tests are ordered to rule out infection or other medical/rheumatologic conditions.


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