Pediatric Spondylolisthesis & Spondylolysis

Question 1

Spondylolisthesis and spondylolysis is more common in what pediatric population?

Answer 1

Athletes, especially with hyperextension

As high as 47% in gymnasts, football lineman and weight lifters

Question 2

What is the most common location for pediatric spondylolisthesis?

Answer 2

L5/S1 (90%)

In adults it is L4/L5

Question 3

What is the next step in management for with an L3 pars defect that has failed non-operative management?

Answer 3

Pars interarticularis repair

For L1-L4 can repair, L5 and S1 require posterior fusion

Question 4

In a patient has a Low Grade L5-S1 isthmic spondylolisthesis with minimal symptoms, that is playing football what is the best management?

Answer 4

Observation. Contact sports are not contraindicated if asymptomatic and low grade

Question 5

What additional diagnostic test is most sensitive to diagnose pediatric spondylolysis when AP and lateral radiographs are normal?

Answer 5

SPECT scan
AP and lateral radiographs show 80% of defects
Oblique radiographs another 15%