L5/S1 spondylolisthesis secondary to spondylosis

Case contributed by Dr Hisham Alwakkaa

Diagnosis certain

Presentation

Patient presented to the ER with abdominal and back pain following skiing injury.

Patient Data

Age: 11 years

Gender: Male

From the case: L5/S1 spondylolisthesis secondary to spondylosis

X-ray

Lateral

The posterior arch or L5 is Hypoplastic. There is vertical lucent line through the pars interarticularis of L5. Grade I anterolisthesis of L5 on S1 also presents.

From the case: L5/S1 spondylolisthesis secondary to spondylosis

X-ray

Lateral

Red arrow is pointing to the pars defect

Purple arrow is pointing to the anterolisthesis of L5 over S1.

From the case: L5/S1 spondylolisthesis secondary to spondylosis

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Axial bone window

Developmental hypoplasia of the posterior arch of L5 associated with bilateral pars defect of L5, with resulting grade I anterolisthesis of L5 over S1. Spina bifida occulta of L5 and sacrum is present.

Case Discussion

Typical findings of spina bifida occult with additional pars defects and resulting spondylolisthesis, detected incidentally during a trauma workup. This is an important finding as it should be confused for a traumatic injury.