A report and commentary on a series of cases of spondylolisthesis

Abstract

A report and commentary on a series of cases of spondylolisthesis: written for the Pattison Prize in Clinical Surgery and Robert Jones Prize in Orthopaedic Surgery, 19351. That spondylolisthesis occurrs equally in males and females.

2. That it is due primarily to a congenital abnormality in the appearance of five centres of ossification of the vertebra instead of the usual three, and that trauma on such an abnormality will precipitate the condition.

3. That an advanced degree of spondylolisthesis can be present in an individual without causing any disturbing symptoms - in fact without that individual knowing that there was any abnormality of his spine present; and that a very slight slipping can cause severe pain and discomfort.

4. That the presence of such a condition impairs the stability and strength of the lumbo-sacral joint, and also causes difficulty in childbirth by reducing the diameter of the pelvic outlet.

5. That the characteristic bow -like outline of the 5th lumbar vertebra on entero- posterior radiography, projected against the shadow of the flat sacrum is pathognomonic.

6. That treatment should aim at arthrodesing the body of the 5th lumbar vertebra to the sacrum, rather than ankylosing the spinous processes of the lumbar and sacral vertebrae. Cure cannot be effected but further displacement can be prevented by efficient surgical treatment.