Spine

Spondylolisthesis

Mechanism

Forward slippage of one vertebra over the one below, usually L5 over S1. In young people from a stress fracture of the pars interarticularis, in older people from degeneration of facet joints and disc.

Recognition

Low back pain increasing on extension and prolonged standing, sometimes with radiation. With a larger slip a step is palpable between two spinous processes.

Course

In young athletes in extension sports it is an important cause of persisting back pain and warrants imaging. In older people the degree of slip is a weak predictor of complaints.

Structures

• Multifidus, lumbar part
• Lumbar vertebrae (L1–L5)

Joints involved

• Facet joints (artt. zygapophysiales)

Clinical tests

• Prone instability test
• Posteroanterior pressure

Sources

• Swart NM, Apeldoorn AT, Conijn D, Meerhoff GA, Ostelo RWJG (red.). KNGF-richtlijn Lage rugpijn en lumbosacraal radiculair syndroom. Koninklijk Nederlands Genootschap voor Fysiotherapie / VvOCM. Amersfoort. 2021 https://www.kngf.nl/kennisplatform