Clinical Evaluation of Pediatric Patient with Spondylolisthesis

Abstract

Pediatric patients presenting with spondylolisthesis require a thorough physical examination. While the majority of these patients will present with back pain, occasionally the initial finding is simply spinal deformity or abnormal gait. Reported symptoms may be minimal in the pediatric population with spondylolisthesis, regardless of the degree of deformity, so a careful and complete physical exam is necessary to document all associated deficits. The exam begins by documenting a thorough history including presenting symptoms, duration, and aggravating or relieving factors. A general inspection of the spinal posture, palpation, spinal range of motion assessment, gait abnormalities, a complete neurologic exam, and special physical exam tests are needed as well. Complaints or findings of motor weakness, sensory changes, or urologic abnormalities which are identified require further evaluation or imaging. In general, despite the range of severity of presenting symptoms found in pediatric patients with spondylolisthesis, evaluating all patients with this thorough physical exam will allow the treating physician to fully assess the impact of the spinal pathology and select appropriate treatment.