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.