Spondylolysis and spondylolisthesis in the pediatric and adolescent population

• Published in: Child's nervous system Vol. 17; no. 11; pp. 644 - 655
• Main Authors: LOGROSCINO, G, MAZZA, O, AULISA, A. G, PITTA, L, POLA, E, AULISA, L
• Format: Journal Article
• Language: English
• Published: Berlin Springer 01.11.2001
• Subjects: Adolescent; Arthrodesis - methods; Biological and medical sciences; Child; Diseases of the osteoarticular system; Diseases of the spine; Humans; Magnetic Resonance Imaging; Medical sciences; Spondylolisthesis - classification; Spondylolisthesis - diagnostic imaging; Spondylolisthesis - therapy; Spondylolysis - classification; Spondylolysis - diagnostic imaging; Spondylolysis - therapy; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed; Human; Spondylolisthesis; Radiodiagnosis; Spine; Diseases of the osteoarticular system; Spine disease; Review; Surgery; Adolescent; Classification; Arthropathy; Arthrodesis; Degenerative disease; Diagnosis; Osteoarthritis
• ISSN: 0256-7040; 1433-0350
• DOI: 10.1007/s003810100495

This article is a review of spondylolysis and spondylolisthesis in younger age groups. Since Herbinaux first described the pathology (1782), many classifications and theories of etiopathogenesis have been proposed. The congenital and isthmic types, as classified by Wiltse, are the most frequent in younger age groups, but the postsurgical progressive forms (3-5%) have been described as increasing in frequency secondary to neoplastic surgery in children. The general incidence is 4-5% at the age of 6 years, and in 30-50% of cases these types do not progress to spondylolisthesis. Most cases are asymptomatic (80%). Standard radiographic examinations (A-P, L, Oblique) are helpful in diagnosis and can suggest what the prognosis will be in terms of the evolution, and also what treatment is indicated (degree of slippage, slip angle, lumbar and lumbosacral index, SPTI). A bone scan (PBS and SPECT) is useful in the early stages of spondylolysis (pre-spondylosis). Although the CT scan is the most accurate examination, MRI is becoming important for diagnosis because of the frequency with which it is used as a primary investigation method. Depending on patient age, progression, degree of slippage, and symptoms, different therapeutic approaches have been proposed and are described in this paper.