Dynamic Chiropractic

Dynamic Chiropractic Facebook Twitter
Dynamic Chiropractic
Find
Advanced Search
Wellness Blog
Dynamic Chiropractic PracticeINSIGHTS
Current Graphic
Facebook
Dynamic Chiropractic – August 14, 2005, Vol. 23, Issue 17
Dynamic Chiropractic
Printer Friendly Email a Friend PDF RSS Feed
Share |
Dynamic Chiropractic

Isthmic vs. Degenerative Spondylolisthesis: Using the "Wide Canal Sign"

By Deborah Pate, DC, DACBR

Spondylolisthesis is generally defined as the anterior shift of one vertebral body on another (the segment below it). It is a well-recognized disorder that can cause lower back pain and radiculopathy.

Two of the more common causes for a spondylolisthesis are degenerative joint disease of the lumbar facets, allowing anterior slippage of the vertebral body in relation to the one below; and a defect in the pars interarticularis.

Generally, oblique views are performed to visualize the pars interarticularis if there is a spondylolisthesis. Sometimes, however, the oblique view is not helpful because of marked degenerative facet changes that obscure the pars. The cause of the spondylolisthesis needs to be determined because the clinical management will be different, depending on the cause.

image - Copyright – Stock Photo / Register Mark

 By using the simple anatomic concept that a spondylolisthesis associated with a break in the pars will demonstrate an increase in the sagittal diameter of the spinal canal, the two etiologies can be differentiated. Using the lateral view, determine the diameter of the spinal canal. A simple method is to use the middle of the posterior margin of the vertebral body and the spino-laminar junction as an estimate of the spinal canal, and compare the level with the spondylolisthesis and the adjacent levels. If there is no significant change in the measurement, it is unlikely that a pars defect is causing the spondylolisthesis (see figure above).

This concept is just a guide for determining if there is a lysis of the pars. Further imaging may be necessary to determine if there are other complications, particularly with marked degenerative changes.

Just as a caveat, there is an additional test you can use to determine whether there is anterior spondylolisthesis. This is the right-angle test. An angle is drawn perpendicular to the anterior margin of the sacrum and along the superior margin of the sacrum (see example below).

image - Copyright – Stock Photo / Register Mark

image - Copyright – Stock Photo / Register Mark

 

 

 

 

 

 

 

 

 
Deborah Pate, DC, DACBR
San Diego, California


Click here for more information about Deborah Pate, DC, DACBR.

Dynamic Chiropractic

Dynamic Chiropractic
Printer Friendly Email a Friend PDF RSS Feed
Share |
Dynamic Chiropractic
Dynamic Chiropractic
Join the conversation
Comments are encouraged, but you must follow our User Agreement
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.
comments powered by Disqus
Dynamic Chiropractic
Have you ever contacted a local employer about the possibility of directing their corporate wellness program?
Yes, contacted
Yes, directing
Thinking about it
No

Sign Up for Our Webinars
Receive Advanced Notice of Future Webinars

 


Generic Viagra Lowest Prices Pfizer Drugs Viagra No Prescription Order Viagra Online Viagra Non Prescription Deal Sale Prescription Viagra Uk Online Levitra Reviews Viagra Oysters In Australia Viagra Price Australia Cialis Pill Color Generic Viagra Canada Buy Cheap Viagra Viagra Katelaris P Viagra Australia Cheap Levitra Prescription Or Not Viagra Levitra Usual Dosage Buy Tadalafil Cialis Online Viagra And Daibetes Viagra Tablets Uk Viagra Online From Us Pharmacys Generic Money Viagra Cialis And Priligy Next Dat Delivery Generic Viagra Vigora 5000 Effect Viagra Drug Interactions Online Levitra Tablet Viagra Buy Online Levitra Drug Interaction Walgreen Viagra Per Pill Viagra Online Gr 4.26 Buy Cialis Lowest Price Viagra Online Cheap Mexico Viagra Buying Free Sale Viagra Cheap Kamagra Viagra Buy Generic Online Viagra Viagra Online Sales Brand Viagra For Get Viagra Without Prescription Viagra Side Effects Blood Pressure Cialis For Sale In Us Australia Viagra Online Cialis Cheap Visa Auk Cialis Sales Bravejournal Buy Levitra Member Levitra Buy Online Find Cheap Cialis Vardenafil 20 Mg Hcl