Clinical features
The clinical features of lumbar spondylolisthesis are somewhat indiscrete:
- age of onset: - dysplasia and spondylosis most usually affects adolescents and young adults - the degenerative form usually occurs beyond middle age, often in women
- chronic backache: - radiating into the buttocks - with or without sciatica - backache is worse on standing, after exercise or straining
- spinal movements may be reduced in older patients, but are usually normal in younger cases.
- a visible or palpable 'step' may be felt above the sacral crest due to a forwards displacement of the spinal column; this tends to be obvious only in severe displacement.
- lumbar vertebral bodies may be palpable through the abdominal wall
- straight leg raising may be impaired due to irritation of a spinal root
- on examination, the buttocks look flattened and there are obvious transverse loin creases
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