Spondylolysis and spondylolisthesis

Case contributed by Dr Ahmed Abdrabou

Presentation

Back pain radiating to both lower limbs of several weeks duration.

Patient Data

Age: 15 years old
Gender: Male

Minimal anterior slippage of L5 over S1 vertebra secondary to bilateral L5 pars interarticularis defect with mild L5-S1 pseudodisc bulge not compromising the neural foramina

Annotated image

The black circle refers to the defect in pars interarticularis.

Case Discussion

Pars interarticularis defect occurs following stress or repititive microtrauma. Bilateral pars fracture may lead to spondylolithesis with the vertebra slipped on the vertebra below dragging its nerve root against the normally placed disc (so termed pseudobulge) which results in patient's symptomatology.

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