Clinical tests to diagnose lumbar spondylolysis and spondylolisthesis

The objective of present paper was to systematically review the diagnostic ability of clinical tests to detect lumbar spondylolysis and spondylolisthesis. The systematic search resulted in a total of 5164 articles with 57 retained for full-text examination, from which 4 met the full inclusion criteria for the review. Study heterogeneity precluded a meta-analysis of included studies. Fifteen different clinical tests were evaluated for their ability to diagnose lumbar spondylolisthesis and one test for its ability to diagnose lumbar spondylolysis. The one-legged hyperextension test exhibited low to moderate sensitivity (50-73) and low specificity (17-32) to diagnose lumbar spondylolysis, while the lumbar spinous process palpation test was the optimal diagnostic test for lumbar spondylolisthesis; returning high specificity (87-100) and mixed sensitivity (60-88) values.

Lumbar spondylolysis and spondylolisthesis are identifiable causes of LBP in athletes. There seems to be utility to lumbar spinous process palpation for the diagnosis of lumbar spondylolisthesis, although the one-legged hyperextension test has practically no value in diagnosing patients with spondylolysis.