Spondylolisthesis - Signs and Symptoms - Degenerative

Degenerative

Patients with isthmic spondylolisthesis almost universally have a neural arch defect, meaning widening of the central spinal canal at the level of the slip. In contrast, in degenerative spondylolisthesis the forward translation of the vertebral body also causes narrowing of the central spinal canal at the level of the slip. This narrowing of the canal has been termed the "napkin ring effect", an illustrative description as one imagines the spinal canal as a series of napkin rings with one of the rings slid forward in comparison to the others. The classic symptomology of patients with symptomatic degenerative spondylolisthesis are similar to those with symptomatic lumbar spinal stenosis; which can be either neurogenic claudication or radiculopathy (either unilateral or bilateral radiculopathy) with or without low back pain.

Neurogenic claudication is thought to result from central canal narrowing that is exacerbated by the listhesis (forward slip). The classic symptoms of neurogenic claudication are bilateral (both legs) posterior leg pain that worsens with activity, but is relieved by sitting or forward bending.