Describe the Wiltse classification of spondylolisthesis Fig 381

• Type 1: Dysplastic: Associated with a congenital deficiency of the L5-S1 articulation

• Type 2: Isthmic: Associated with a lesion in the pars interarticularis

• Subtype 2A: Lytic defect (stress fracture) of the pars

• Subtype 2B: An elongated or attenuated pars

• Subtype 2C: An acute pars fracture

Figure 38-1. Wiltse classification of spondylolisthesis. (From Neuwirth MG. Spondylolysis and spondylolisthesis in children and adults. In: Comins M, O'Leary P, editors. The Lumbar Spine. New York: Raven Press; 1987. p. 258, with permission.)

• Type 3: Degenerative. Disc degeneration and facet arthrosis lead to spondylolisthesis and associated spinal stenosis

• Type 4: Traumatic. An acute fracture in a region of the posterior elements other than the pars interarticularis (e.g. facets, pedicle, lamina) leads to spondylolisthesis

• Type 5: Pathologic. Generalized bone disease (e.g. metabolic, neoplastic) results in attenuation of the pars and/or pedicle region leading to spondylolisthesis

• Type 6: Postsurgical Spondylolisthesis that develops following lumbar laminotomy or laminectomy

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