Synonyms and related keywords: lumbosacral spondylolisthesis, isthmic spondylolisthesis, spondylolysis, hyperextension of the lumbar spine, lumbar spine hyperextension, hyperextended back, hyperextended spine, back pain, lower back pain, low back pain, LBP, spondylolytic spondylolisthesis, lytic spondylolisthesis, pars interarticularis stress fracture, spine stress fracture
Author: Adam E Perrin, MD, FAAFP, Consulting Staff, Spine and Sports Center of Connecticut; Community Preceptor, Family Practice Residency Program, Middlesex Hospital
Coauthor(s): Brian J Shiple, DO, Chief, Director of Primary Care Sport, Department of Family Medicine, Division of Sports Medicine, Clinical Assistant Professor, Crozer-Keystone Health Systems
Spondylolisthesis is defined as forward translation of a vertebral body with respect to the vertebra below. The term is derived from the Greek roots spondylo, meaning spine, and listhesis, meaning to slide down a slippery path. Spondylolisthesis can occur at any level of the spinal column, although it is most common in the lower lumbar spine. Most cases are thought to result from minor overuse trauma, particularly repetitive hyperextension of the lumbar spine. Spondylolysis, a break in the vertebra typically in the region of the pars interarticularis, may or may not be associated with a spondylolisthesis. If the pars defect is bilateral, it may allow slippage of the vertebra, typically L5 on S1, resulting in spondylolisthesis.
Both spondylolysis and spondylolisthesis are often asymptomatic, and the degree of spondylolisthesis does not necessarily correlate with the incidence or severity of symptoms, even when a patient is experiencing back pain. However, these 2 entities have been reported to be the most common underlying causes of persistent low back pain among children and adolescents, despite the fact that most cases are asymptomatic.