SPONDYLOLYSIS AND
SPONDYLOLISTHESIS
IN THE ATHLETE

John T. Stinson, MD



Spondylolysis and spondylolisthesis are common causes of back and leg pain in the athletic population. Spondylolysis originates most often in children between 5 and 10 years of age with an overall incidence in the general population of approximately 5% .56 Athletically acquired spondylolysis is a stress fracture through that part of the lamina between the superior and inferior articular facets named the pars interarticularis (Fig. 1). Many types of athletic activities requiring lumbar extension or extension and rotation place the immature spine at risk for developing these lesions.


HISTORY, TERMINOLOGY, CLASSIFICATION

The term spondylolisthesis was coined in 1854 by Kilian,22 who theorized its basic mechanism to be a gradual subluxation of the lumbosacral facet due to superimposed body weight. This condition stimulated the interest of obstetricians who identified it as a cause of obstruction of labor .20 Its derivation is from the greek spondylos for "vertebra" and olisthein meaning "to slip." Robert,33 in 1855, was the first to localize a lesion in the neural arch demonstrating through dissection that such a defect is a necessary precondition for slippage. It was later demonstrated that slippage could occur with an intact but elongated pars interarticularis.27

From the Department of Orthopaedic Surgery, Georgetown University School of Medicine, Washington, DC; and Orthopaedic Section, Shady Grove Adventist Hospital, Rockville, Maryland

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CLINICS IN SPORTS MEDICINE

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