Lumbar Degenerative
A 16-year-old female gymnast presents with progressive low back pain worsened by extension activities. She has bilateral leg pain and hamstring tightness. Examination shows a palpable step-off at L5, hyperlordotic posture, and tight hamstrings. Standing lateral radiographs show forward slippage of L5 on S1 with the posterior cortex of L5 at the midpoint of the S1 body. Oblique views show bilateral pars defects ("scotty dog" collars). Regarding spondylolisthesis:
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The Wiltse classification categorizes spondylolisthesis by etiology: Type I (dysplastic - congenital...
The Meyerding classification grades slip severity based on percentage of vertebral body translation:...
Degenerative spondylolisthesis is most common in adolescents; the pars defect is the hallmark of deg...
Clinical features of isthmic spondylolisthesis include low back pain worse with extension, hamstring...
Treatment is grade-dependent: low-grade (I-II) stable slips may be managed with activity modificatio...
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Click T (True) or F (False) for each option