Wiltse et al classified spondylolisis and spondylolisthesis based on the underlying cause, which can influence the course and management of the disease. The authors are from Memorial Hospital Center and Earl and Loraine Miller Children's Hospital Medical Center in Long Beach, California.
Features
Process
Type
congenital dysplasia/abnormality of upper sacrum or neural arch of L5
dysplastic
I
lytic-fatigue fracture of the pars interarticularis
isthmic, lytic
IIA
elongation of an intact pars interarticularis secondary to repeated fatigue microfractures (variant of Type IIA)
isthmic, elongation
IIB
acute traumatic fracture of the pars interarticularis
isthmic, acute fracture
IIC
secondary to chronic intersegmental instability
degenerative
III
fracture in areas of the bone hook other than the pars interarticularis
traumatic
IV
generalized or localized non-traumatic bone disease
pathological
V
where:
• Olisthesis refers to slipping of the bones of a joint away from the normal relationships.
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