Imaging techniques for the diagnosis of spondylolisthesis

This chapter reviews the imaging techniques used in the evaluation of spondylolisthesis. Available modalities include radiography, magnetic resonance imaging (MRI), computed tomography, and scintigraphy. Optimal utilization of these techniques can result in an accurate assessment with little or no risk to the patient. The strengths of each modality will be discussed along with the limitations so that the reader can gain a sense of how to proceed with the diagnostic workup. The diagnosis of spondylolisthesis is usually first made on radiography which may or may not be performed with the specific diagnosis in mind. The severity of disease can be established and stability can be assessed. MRI is usually the next step if more information is needed regarding spinal canal or neural foraminal compromise. Computed tomography yields superior visualization of bone detail, particularly useful in the diagnosis of spondylolysis. Scintigraphy depicts metabolic changes in areas of bone turnover. Examples of findings in each modality in cases of spondylolisthesis will be provided, along with a discussion of the differences in imaging findings in spondylolisthesis according to the etiology of disease.