Spondylolysis and spondylolisthesis in the child and adolescent: a new classification.
Spondylolysis and spondylolisthesis commonly are diagnosed in children and adolescents. The diagnostic workup and treatment plan vary widely among physicians. Although the orthopaedic literature is extensive on the topic, it is our opinion that a lack of clarity exists with regards to etiology, terminology, subtypes of spondylolysis and spondylolisthesis, and treatment. Important basic principles regarding spondylolysis and spondylolisthesis, with emphasis on clinical evaluation and nonsurgical treatment, serve as the basis for a new classification. We propose a new classification for pediatric spondylolysis and spondylolisthesis that is comprehensive, simple, and easily applied. This scheme is based on clinical presentation and spinal morphology and is more appropriate for the child and adolescent than the existing classification schemes of Wiltse-Newman and Marchetti-Bartolozzi. Algorithms for evaluation and treatment of spondylolysis and spondylolisthesis in children and adolescents, based on this new classification, are presented.
Herman
Martin J
MJ
Drexel University College of Medicine and St. Christopher's Hospital for Children, Philadelphia, PA, USA. Martin1.Herman@tenethealth.com
Pizzutillo
Peter D
PD
D000293:Adolescent; D017677:Age Distribution; D001915:Braces; D002370:Casts, Surgical; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D015994:Incidence; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D008297:Male; D008403:Mass Screening / Q000379:methods; D026741:Physical Therapy Modalities; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D013128:Spinal Osteophytosis / Q000145:classification* / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000628:therapy; D013168:Spondylolisthesis / Q000145:classification* / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000628:therapy; D014057:Tomography, X-Ray Computed