least helpful for the diagnosis of spondylolisthesis is ?
*All the given radiological investigation are used for spondylolisthesis. However, AP x-ray of spine is least helpful as in low grades of spondylolisthesis it may be normal. *On the other hand lateral x-ray, CT and MRI diagnose even the mildest degree of spondylolisthesis. *It is woh nothing that spondylolysis may be missed on lateral x-ray and MRI. CT scanning is more sensitive in diagnosing spondylolysis. *The given X- ray is showing a forward displacement of the arrow- marked veebra on lower one, suggestive of Spondylolisthesis. Definition Anterior displacement (antero-listhesis) of a veebral body upon the bottom veebral body Usually occurs between L4-L5 and between L5-S1 Generally occurs in families Posterior displacement: retro-listhesis Pathology In the standing position there is a constant downward and forward force on the lower lumbar veebrae Body mass and normal movement may give rise to spondylolisthe The anatomical structure of the lumbo-sacral area of the veebral column is affected Pathology The degree of antero displacement is explained in Grades Ito IV These grades each comprise a quaer of the surface of the bottom veebrae u Grade I and Ills treated conservatively Grade III and IV should undergo a fusion Signs and symptoms Back or leg pain Back feels weak Sometimes lumbar scoliosis and increased kyphosis Step is felt in the back Unilateral and sometimes bilateral nerve root compression with pain in the legs Segmental instability Stiff back extensors, hamstring and m psoas - attempt to stabilise the pelvis Treatment Asymptomatic: No treatment Symptomatic: Severe cases - bed static traction localised heat analgesics rest Ref: Essential of skeletal radiology 3rd/e p.380
AP x- ray of spine
Lateral x-ray of spine
MRI
CT
Spinal injuries