Diagnosis of Spondylolisthesis

Differential Diagnosis of Spondylolisthesis

There are a numerous reasons that a person may experience back pain and these must be ruled out before the relationship between back pain and spondylolysis or spondylolisthesis can be determined.

Other causes of back pain may include:

• Lumbosacral strain - problem lies in the muscles or ligaments. This is often the case for an adult who has been pain free and suddenly develops lower back pain.
• Radiculopathy caused by compression or irritation of the nerve roots by degeneration or herniation of the intervertebral disk
• Intermittent claudication due to vascular insufficiency which reduces blood circulation to muscles during walking or neurologic causes (e.g., peripheral neuropathy)
• Poor muscle tone and spinal alignment
• Arthritis
• Juvenile osteoporosis
• Osteosarcoma
• Congenital hypoplasia of the spine - incomplete development of any part of the spine

Evaluating the pain pattern (i.e., is it acute or chronic; what conditions bring on or worsen the pain; what relieves the pain) may be helpful in differentiating spondylolisthesis from other potential sources of pain.

Refractory radicular pain may be due to:

• A pinched nerve
• Movement of a segment of a cracked vertebra
• Irritation of nearby disks
• Spinal stenosis - narrowing of the spinal canal