The natural history of spondylolysis and spondylolisthesis.

TLDR

A prospective radiographic study of 500 first‑grade children from 1955–1957 followed their families to determine the incidence of spondylolysis, spondylolisthesis, or both. Spondylolysis occurred in 4.4 % of six‑year‑olds and 6 % of adults, spondylolisthesis reached 28 % with rare progression, and the data suggest a cartilaginous anlage defect, hereditary predisposition, and strong link to spina bifida occulta, with slips unlikely to progress after adolescence and never symptomatic in this cohort.

Abstract

We performed a prospective roentgenographic study to determine the incidence of spondylolysis, spondylolisthesis, or both, in 500 unselected first-grade children from 1955 through 1957. The families of the children with spondylolysis were followed in a similar manner. The incidence of spondylolysis at the age of six years was 4.4 per cent and increased to 6 per cent in adulthood. The degree of spondylolisthesis was as much as 28 per cent, and progression of the olisthesis was unusual. The data support the hypothesis that the spondylolytic defect is the result of a defect in the cartilaginous anlage of a vertebra. There is a hereditary pre-disposition to the defect and a strong association with spina bifida occulta. Progression of a slip was unlikely after adolescence and the slip was never symptomatic in the population that we studied.