How Do Doctors Diagnose Spondylolysis and Spondylolisthesis?

The Diagnostic Journey

Proper diagnosis of spondylolysis and spondylolisthesis is crucial for effective treatment. Learn about the tests doctors use to identify these conditions.
Initial Imaging Tests
When a young athlete presents with persistent back pain, doctors often start with plain X-rays of the lumbar spine. These images can reveal fractures or vertebral slippage, but may not always show early-stage injuries. If X-rays are inconclusive, further imaging is usually necessary.
Advanced Imaging Techniques
MRI is the preferred method for assessing spinal injuries without radiation exposure. It detects early signs of stress fractures and bone edema. SPECT scans are another option, providing detailed images but with higher radiation exposure compared to MRI.
Spondylolysis is a stress fracture in the vertebrae, while spondylolisthesis involves the slippage of a vertebra. Proper diagnosis through imaging tests is essential for effective treatment.
When to Consider CT Scans
CT scans are highly accurate for detecting bone abnormalities but involve significant radiation. They are typically reserved for cases where MRI is unavailable or when precise bone detail is needed to determine the stage of injury and guide treatment decisions.
TL;DR · FAQs
  • Q: What's the first step in diagnosis?
    A: Doctors usually start with X-rays of the lumbar spine.
  • Q: Why is MRI preferred over CT?
    A: MRI avoids radiation and detects early signs of injury.
  • Q: When are SPECT scans used?
    A: They're used when high detail is needed but involve higher radiation.
  • Q: Are CT scans always necessary?
    A: No, they're used when MRI isn't an option or more detail is needed.

Wrapping Up

Accurate diagnosis requires a combination of clinical evaluation and appropriate imaging.
Curious about the right diagnostic test for your condition? Consult Doctronic today.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic.
Additional References
  1. Tofte JN, CarlLee TL, Holte AJ, et al. Imaging Pediatric Spondylolysis: A Systematic Review. Spine (Phila Pa 1976) 2017; 42:777.
  2. Masci L, Pike J, Malara F, et al. Use of the one-legged hyperextension test and magnetic resonance imaging in the diagnosis of active spondylolysis. Br J Sports Med 2006; 40:940.