Spondylolysis and spondylolisthesis in children and adolescents: current concepts and treatment

Spondylolysis and spondylolisthesis usually affect the lumbosacral junction and are the most common causes of back pain in children and adolescents. In severe forms the deformity may be progressive and produce neurological deficits, sagittal imbalance and physical disability. The mainstay of treatment in early stages is conservative, while surgery is offered in persistently symptomatic patients or progressive deformities. Severe forms of spondylolisthesis require spinal stabilization and deformity correction; however there is lack of consensus regarding the optimal operative management. The aim of this article is to present the current concepts on the development, progression and classification of this condition, to illustrate the clinical and imaging diagnostic approaches and describe the principles of surgical treatment in all stages of the disease.