Spondylolisthesis

Spondylolisthesis is the displacement of one vertebra relative to the vertebra below and is typically a progression of spondylolysis, which is a deformity of the pars interarticularis. Displacement typically occurs in the anterior direction but can also occur, although rarely, in the posterior or lateral directions (Metz & Deviren, 2007). Prevalence is around 3-6% of the population and it is found in 50% of people with low back pain (Foreman et al., 2013; Lane Wimberly & Lauerman, 2002). “Spondylolisthesis” comes from the Greek words for vertebra slippage (Mohrika et al, 2010). Spondylolisthesis is categorized into 5 grades of severity by Meyerding’s classification system, which is based on displacement of the superior vertebral body relative to the inferior one. Grade 1 is a 0-25% displacement, grade 2 is 26-50%, grade 3 is 51-75%, grade 4 is 76-100%, and grade 5 is greater than 100% (Metz & Deviren, 2007). If not treated properly, the severity of spondylolisthesis can progress to higher grades. This progression is more likely in females than males (Metz & Deviren, 2007). The gymnast in the given scenario has grade 2 spondylolisthesis.
This is where the defect in spondylolysis and spondylolisthesis most often occurs (Jackson et al, 1981). The majority of the force placed on the vertebrae in sports is absorbed by the pars (Letts et al, 1986). Interestingly, spondylolisthesis is most commonly seen at L5 (5th lumbar vertebra), however the lumbosacral junction and middle lumbar spine are seen to be the areas of injury commonly observed as well (Foreman et al., 2013). Lesions can also be found in the cervical, or on rare occasions in the thoracic vertebra (Metz & Deviren,