Wiltse classification of spondylolisthesis

Last revised by Arlene Campos on 10 Sep 2024

The Wilste classification of spondylolisthesis is based on the etiology of the slip but does not grade severity nor assist with management 1,2.

Typically, when reporting studies with spondylolisthesis, the Wiltse type is merely described without referring to its number, whereas the grade of spondylolisthesis is explicitly stated: e.g. "Grade 1 degenerative spondylolisthesis of L5 on S1" rather than "Grade 1, Type III spondylolisthesis".

The Wilste classification of spondylolisthesis is as follows 1:

  • type I (dysplastic/congenital): translation is secondary to an abnormal vertebral arch

  • type II (isthmic): translation is secondary to a lesion involving the pars interarticularis

    • subtype a (lytic): secondary to stress fracture, in most cases attributed to repeated extension and/or twisting motions

    • subtype b (elongated pars): result of multiple injury/healing events leading to elongation of the pars

    • subtype c (acute pars fracture): secondary to a single event and is rare

  • type III (degenerative): result of chronic instability and intersegmental degenerative changes

  • type IV (post-traumatic): fracture in a region other than the pars leading to slippage

  • type V (pathological): diffuse or local disease compromising the usual structural integrity that prevents slippage

  • type VI (iatrogenic)

This classification was proposed by Leon L. Wiltse in 1981 1.

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