Biomechanical Considerations and Mechanisms of Injury in Spondylolisthesis

Lumbar spondylolisthesis presents a formidable challenge to the complex biomechanical properties inherent to this region of the spine. Anatomical malalignment of the lumbar spine in the sagittal plane secondary to spondylolisthesis alters both the kinematic and load distribution patterns in the three predominant loading classifications, resulting in a pathomechanical response of the lumbopelvic spine and global sagittal balance. From a biomechanical standpoint, the mechanisms of injury and grade of spondylolisthesis affect the three longitudinal columns of spinal stability, degenerative processes of the three-joint-complex, and efficiency of the lumbosacral spine to optimally transmit load and motions in the axial skeleton.