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Aetiology and pathology

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Normally, slipping of one vertebrae upon the another is prevented by the engagement of its articular process with those of the segment next below it. A failure of this check mechanism produces spondylolisthesis. This may arise in five situations:

  • slipping at a spondylolysis of the pars interarticularis:
    • caused by a fatigue fracture
    • the most common form of spondylolisthesis

  • degenerative osteoarthritis:
    • mechanical wear of the posterior facet joints may result in vertebral slipping
    • the main problem is degenerative disc disease
    • it is most most common in women over the age of 55 years

  • dysplastic:
    • a congenital deficiency of the posterior facet joints
    • this is most common at the lumbo-sacral joint allowing the L5 vertebra to slip forwards off S1
    • it is a rare condition, more common in girls than boys
    • complete displacement may produce a cauda equina syndrome

  • trauma - very rarely, spondylolisthesis may result from an acute traumatic fracture, or a pathological fracture through a tumour

  • pathological - weakening of the pars interarticularis by tumours and osteoporosis

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