Certain clinical and radiographic findings may indicate that a child or adolescent with spondylolisthesis may have an increased risk for continued pain, deformity or disease progression.
Clinical risk factors:
(1) early age of onset (spondylolisthesis progresses during the adolescent growth spurt in ages 10-15 years)
(2) female (greater risk of additional slippage and development of severe grades)
(3) recurrent episodes of pain in the back
(4) presence of deformity (postural deformity, abnormal gait due to tight hamstrings)
Radiographic risk factors:
(1) dysplastic (type I)
(2) Meyerding Grade III or IV degree of slip (see below)
(3) increasing angle of slip
(4) instability with a "teeter-totter: appearance (dome-shaped, vertical sacrum and trapezoidal fifth lumbar vertebral body, and lack of sclerotic change at L5-S1)
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