Spondylolisthesis, Pars Defect & Stress Fracture

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What Is Spondylolisthesis?

Spondylolisthesis refers to the forward slipping of one vertebra over another, most commonly occurring in the lumbo-sacral region. This condition typically results from damage to the back portion of the vertebra, which plays a crucial role in stabilising the spinal segment. When this structure is compromised, it can lead to the anterior slipping of the vertebra.

What Is A Pars Defect?

A pars defect is a stress fracture in the pars interarticularis, located in the back portion of the vertebra. In many cases, a pars defect in the lumbar spine is associated with spondylolisthesis. The severity and type of slippage determine the stability of the affected vertebra. While spondylolisthesis is not gender-specific, it is influenced by activity levels.

Types Of Spondylolisthesis

There are various forms of spondylolisthesis, but the two most common types are:

  • Isthmic Spondylolisthesis: Predominantly affects children over the age of five.
  • Degenerative Spondylolisthesis: Commonly occurs in the older or elderly population.

Causes Of Spondylolisthesis & Pars Defects

Spondylolisthesis and pars defect have been shown to be caused by a rapid increase in pressure on the back portion of the vertebra during repetitive movements that involve arching and twisting of the lower back. Any activities which involve loading of the back vertebral structures have an increase risk of developing a pars defect. Some of these activities include gymnastics, weightlifting, bowling in cricket, dancing, rowing, tennis and any throwing activities.

Signs & Symptoms

While many cases of spondylolisthesis are asymptomatic, the following signs and symptoms may occur:

  • Low Back Pain: Pain that develops during extension movements, worsens with daily activities, and becomes more severe by evening.
  • Mechanical Issues: Patients may experience “giving way” or “catching” in the back when rising from a forward position.
  • Postural Changes: Hyperlordosis of the lumbar spine, hamstring tension, and prominent gluteal musculature.
  • Degenerative Symptoms: In older individuals, spondylolisthesis may cause canal stenosis symptoms.