Spondylolysis and spondylolisthesis in paediatric patients: types, investigations and treatment options

Spondylolysis is a defect in the posterior vertebral arch, most commonly in L5, and spondylolisthesis is a forward slippage of a vertebra upon another, in children most commonly L5 on S1. In children, symptomatic spondylolysis generally warrants treatment by activity modifications, and treatment options such as bracing or surgical spondylolysis repair can be considered for specific cases. In progressive, low-grade spondylolisthesis that has failed to respond to conservative treatment options, spinal fusion can be performed to halt progression and correct the local deformity. High-grade spondylolisthesis requires surgical stabilization to prevent further progression of the lumbo-sacral kyphosis and progressive slip, restore global sagittal balance and prevent a decline in long-term quality of life.