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Spondylolisthesis — Wiltse Classification

Wiltse etiologic types: I dysplastic, II isthmic (IIA lytic, IIB elongated pars, IIC acute pars), III degenerative, IV traumatic (other than pars), V pathologic, VI iatrogenic. Meyerding grades I–V (25% increments) quantify slip; slip angle and pelvic incidence inform reduction strategy. Adult degenerative L4–5 listhesis: decompression with fusion when instability/foraminal stenosis present. High‑grade isthmic L5–S1 in adolescents may need reduction and circumferential fusion; monitor for L5 neuropraxia. Nonoperative measures (activity modification, core strengthening) first in low‑grade without neurologic compromise.

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Wiltse etiologic types: I dysplastic, II isthmic (IIA lytic, IIB elongated pars, IIC acute pars), III degenerative, IV traumatic (other than pars), V pathologic, VI iatrogenic. Meyerding grades I–V (25% increments) quantify slip; slip angle and pelvic incidence inform reduction strategy. Adult degenerative L4–5 listhesis: decompression with fusion when instability/foraminal stenosis present. High‑grade isthmic L5–S1 in adolescents may need reduction and circumferential fusion; monitor for L5 neuropraxia. Nonoperative measures (activity modification, core strengthening) first in low‑grade without neurologic compromise.
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Question 1

What is the primary aetiology of Type I spondylolisthesis according to the Wiltse classification?

Question 2

In which age group is Type II isthmic spondylolisthesis most commonly observed?

Question 3

Which subtype of Type II isthmic spondylolisthesis is characterized by a fatigue stress fracture of the pars interarticularis?

Question 4

What is the most common level for degenerative spondylolisthesis?

Question 5

Which grade of Meyerding classification indicates a slip of 51-75%?

Question 6

Which type of spondylolisthesis is most likely to require surgical management?

Question 7

What is the primary nonoperative management strategy for low-grade spondylolisthesis without neurologic compromise?

Question 8

In the context of spondylolisthesis, what does 'spondyloptosis' refer to?

Question 9

Which classification type is associated with acute fractures of the pars interarticularis?

Question 10

In terms of pelvic incidence, what is its relevance in managing high-grade spondylolisthesis?