Spondylolysis and Spondylolisthesis for Postgraduate Orthopaedic Exams

Farhaan Altaf: spondylolysis is a defect of the pars interarticularis of the vertebrae and is one of the most common causes of back pain in adolescents who are very active, especially in hyperextension sports such as gymnastics. There are different types of spondylolysis, with the most common being the Nick type attributed to a stress fracture of the pars from repeated hyperextension. Diagnosing a pars defect can be difficult, but oblique x-rays create a Scottie dog view where the pars interarticularis is seen as a line across the neck of the dog or the collar. Conservative measures are used for managing a patient with back pain and a diagnosis of pars defect, including analgesia, activity restriction, physiotherapy, and bracing for about three months. If conservative measures fail, further imaging with CT or MRI scans may be necessary to plan management, which may involve direct pars repair or lumbar fusion depending on factors such as disc degeneration and degree of slippage. Spondylolisthesis is classified by severity of slippage, and surgery is considered when there is back pain and leg pain, or foraminal or central stenosis.

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This teaching video is specifically helpful for candidates preparing for the following Orthopaedic Exams : FRCS , European Board (FEBOT) , SICOT Diploma and Arabic Boards