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Spondylolisthesis is when one spinal vertebra slips out of place compared to another. [1] While some medical dictionaries define spondylolisthesis specifically as the forward or anterior displacement of a vertebra over the vertebra inferior to it (or the sacrum), [2] [3] it is often defined in medical textbooks as displacement in any direction.
These cannot be determined by plain films, as the x-ray passes through the soft tissue. A study by Giles et al., stated that sixteen of the thirty patients (53%) had retrolisthesis of L5 on S1 ranging from 2–9 mm; these patients had either intervertebral disc bulging or protrusion on CT examination ranging from 3–7 mm into the spinal canal.
The majority of disc herniations occur in the lumbar spine (95% at L4–L5 or L5–S1). [21] The second most common site is the cervical region (C5–C6, C6–C7). The thoracic region accounts for only 1–2% of cases.
The Napoleon hat sign (most commonly called "inverted Napoleon hat") is a radiologic sign observed on frontal radiographs of the spine at the level of the fifth lumbar vertebra (L5) and the sacrum (S1) that indicates the presence of severe spondylolisthesis and/or severe lumbar lordosis.
After the conus medullaris (near lumbar vertebral levels 1 (L1) and 2 (L2), occasionally lower), the spinal canal contains a bundle of nerve fibers (the cauda equina or "horse-tail") that branches off the lower end of the spinal cord and contains the nerve roots from L1–L5 and S1–S5. The nerve roots from L4–S4 join in the sacral plexus ...
Forward displacement of a proximal vertebra in relation to its adjacent vertebra in association with an intact neural arch, and in the presence of degenerative changes, is known as degenerative spondylolisthesis, [9] [10] which narrows the spinal canal, and symptoms of spinal stenosis are common. Of these, neural claudication is most common.
Bertolotti's syndrome is characterized by sacralization of the lowest lumbar vertebral body and lumbarization of the uppermost sacral segment. It involves a total or partial unilateral or bilateral fusion of the transverse process of the lowest lumbar vertebra to the sacrum, leading to the formation of a transitional 5th lumbar vertebra.
In sacralization, the L5-S1 intervertebral disc may be thin and narrow. This abnormality is found by X-ray. [citation needed] Sacralization of L6 means L6 attaches to S1 via a rudimentary joint. This L6-S1 joint creates additional motion, increasing the potential for motion-related stress and lower back pain/conditions.
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