Article Figures & Data
Figures
- Figure 1.
The severity of spondylolisthesis according to the Meyerding classification system divides slip severity into 5 grades: 0% to 25% is Grade I, 25% to 50% is Grade II, 50% to 75% is Grade III, 75% to 100% is Grade IV, and greater than 100% is Grade V, which is referred to as spondyloptosis. Reproduced with permission from OrthoInfo. © American Academy of Orthopaedic Surgeons. https://www.orthoinfo.org/.
- Figure 2.
The pars interarticularis (left) refers to the small segment of bone that joins the facet joints in the spine. Spondylolysis (center) occurs via a stress fracture and subsequent fracture of the pars interarticularis. In the setting of bilateral pars defects, forward translation of the caudal vertebral segment may result, termed isthmic spondylolisthesis (right). Reproduced with permission from OrthoInfo. © American Academy of Orthopaedic Surgeons. https://www.orthoinfo.org/.
- Figure 3.
A young gymnast performing a back-bend position requiring hyperextension of the lumbar spine. Such repetitive maneuvers place stress on the pars interarticularis and predispose patients to develop spondylolysis and subsequent isthimic spondylolisthesis. Reproduced from Sands WA, McNeal JR, Penitente Get al Stretching the Spines of Gymnasts: A Review. Sports Med. 2016;46(3):315 to 327.
- Figure 4.
AP and Lateral standing radiographs of a skeletally mature young athlete demonstrating L5-S1 Meyerding Grade II isthmic spondylolisthesis. Significant disk space collapse corresponds with long-standing low back pain; this patient also presented with L5 radiculopathy due to resultant foraminal stenosis. In addition present on the AP film is a minor thoracolumbar scoliosis which is likely incidental and unrelated to the aforementioned pathology.
- Figure 5.
Lateral radiograph evaluating the slip angle of a patient with high-grade spondylolisthesis. A slip angle greater than 50 degrees is predictive of further slip progression
- Figure 6.
An axial CT scan image demonstrating spondylolysis. The image highlights the cortical disruption and surrounding sclerosis at the area of the pars defect.
- Figure 7.
Lateral and posterior views demonstrating direct screw fixation technique for bilateral pars defect repairs. Reproduced with permission from AO Surgery Reference. © by AOSpine International, Switzerland. http://www.aosurgery.org/.
- Figure 8.
AP and lateral radiographs demonstrating L4-S1 in situ instrumented fusion with fibula allograft for augmentation.
- Figure 9.
Lateral (left) view demonstrating facet removal for a wide decompression and to gain access to the L5-S1 disk space. Following disk removal, an interbody cage is placed at the L5-S1 disk space (right). Care must be taken during reduction due to the proximity of the L5 nerve root. Reproduced with permission from AO Surgery Reference. © by AOSpine International, Switzerland. http://www.aosurgery.org/.
