(11a) A T2-weighted axial image at the L4-5 level reveals severe bilateral facet hypertrophic changes (arrows). This feature is typical of a degenerative etiology of spondylolisthesis, and is rarely found in patients with spondylolysis.
Figure Lumbosacral spine lateral plain X ray image that shows some retrolisthesis of the L vertebral body on the L vertebral body as indicated by the
, A characteristic appearance on x ray ofosteoarthritis most often.
There are four grades of severity of slip, determined by the amount that the upper vertebra has slipped in relation to the lower one. A slip of less than 25% is grade 1, 25-50% is grade 2, 50-75% is grade 3 and 75-100% is grade 4.
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There is an acquired fracture through the portion of the vertebra between the two articular processes. This part of the vertebra is called the pars or pars interarticularis, meaning the part of the vertebra between the adjacent two facet joints.
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The T1-weighted off-midline sagittal image demonstrates a defect in the L5 pars interarticularis with interruption of the cortex and intermediate signal intensity material in the defect (arrow). Slight anterior subluxation of the L5 vertebral body is seen with respect to the S1 vertebral body. Marrow within the L5 posterior elements is of increased signal intensity on the T1 weighted images (arrowheads).
Retrolisthesis of l on l Answers on HealthTap
Lytic spondylolisthesis usually occurs at L5/S1 and normally presents in the teenage years or 20s. The classical example is the so-called fast (cricket) bowler’s “stress fracture”. It occurs due to repetitive stresses in the lumbar spine but it often appears with no obvious history of repetitive trauma.
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Spondylolysis refers to an osseous defect within the posterior neural arch, most commonly within the pars interarticularis, an isthmus of bone located between the superior and inferior articular processes. Spondylolysis most commonly affects the L5 level (in 85 ” 95% of cases) with the majority of the remaining cases occurring at L4 (5 ” 15% of cases).1 While the exact etiology of spondylolysis is unknown, it is generally believed to represent a stress fracture caused by repetitive loading,2 although there are hereditary and genetic contributing factors.
Displacement of the spinal segments
(5a) A 3D illustration of the lumbosacral region demonstrates the typical location of the osseous defect in patients with spondylolysis. Illustration courtesy of Michael E. Stadnick, M.D.