What is the most common subtype of isthmic spondylolisthesis?

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Multiple Choice

What is the most common subtype of isthmic spondylolisthesis?

The main idea is that isthmic spondylolisthesis stems from a defect in the pars interarticularis, most often caused by a fatigue (stress) fracture—the pars becomes weakened from repetitive stress, and when defects occur on both sides, the vertebral body can slip forward. This bilateral pars fracture pattern is especially common in young athletes who perform repetitive lumbar hyperextension, with the slip most often at the L5 level. Other scenarios described—an acute traumatic pedicle fracture, degenerative narrowing of the disc, or disc herniation with pars involvement—do not represent the typical mechanism of the isthmic subtype. So the fatigue fracture of the pars interarticularis is the most common subtype because it directly creates the bilateral defect that enables forward slippage characteristic of isthmic spondylolisthesis.

The main idea is that isthmic spondylolisthesis stems from a defect in the pars interarticularis, most often caused by a fatigue (stress) fracture—the pars becomes weakened from repetitive stress, and when defects occur on both sides, the vertebral body can slip forward. This bilateral pars fracture pattern is especially common in young athletes who perform repetitive lumbar hyperextension, with the slip most often at the L5 level. Other scenarios described—an acute traumatic pedicle fracture, degenerative narrowing of the disc, or disc herniation with pars involvement—do not represent the typical mechanism of the isthmic subtype. So the fatigue fracture of the pars interarticularis is the most common subtype because it directly creates the bilateral defect that enables forward slippage characteristic of isthmic spondylolisthesis.

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