Spondylolisthesis

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Spondylolisthesis denotes the sliding of one vertebra upon another either in the anterior or posterior direction (retrolisthesis). The sliding may be associated with spondylolysis or degenerative diseases such as apophyseal osteo-arthritis and diskovertebral osteoarthritis. The latter type is aptly termed degenerative spon-dylolisthesis or spondylolisthesis with intact neural arch.

Radiographic features include vertebral slippage and endplate eburnation, most commonly in the two lowermost lumbar vertebrae and the lumbosacral joint (Figs. 9.62A and 9.64A). The anterior downward tilt of the displaced vertebral body seen on the lateral view is another diagnostic sign. On the anterior view the downward tilt is indicated by the change of quadrilateral shape of the vertebral body into ovoid shape, arbitrarily termed the "ovoid vertebra" sign. Interestingly, pinhole scintigraphy shows prominent uptake in the ovoid vertebra, which is densely sclerosed (Fig. 9.64B).

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