Clinical presentation and physiotherapy treatment of 4 patients with low back pain and isthmic spondylolisthesis

Spondylolisthesis is a pathological condition characterized by the slipping of a vertebral body, compared with the underlying one, following structural and/or degenerative changes of the spine. The purpose of this case series is to describe clinical presentations and the conservative physiotherapy management of 4 patients with low back pain and lumbar isthmic spondylolisthesis. Four patients aged 25, 43, 36, and 50 years presented with low back pain of various duration. Radiographs confirmed the presence of lumbar isthmic spondylolisthesis. Outcome measures included numerical rating scale, disability outcome measure (Oswestry Disability Index), spinal instability tests (Prone Instability Test, Passive Lumbar Extension test), and muscle function tests (Aberrant Movement Patterns, Active Straight Leg Raising, Prone and Supine Bridge Tests). Treatment consisted of postural reeducation, stretching, and strengthening exercises. Over the course of individualized treatment, ranging from 8 to 10 treatment visits, outcomes improved for all 4 patients. This report describes varying clinical presentations and treatment of 4 patients with isthmic spondylolisthesis, suggesting that different pain generators could be managed by different conservative approaches.