In the most severe cases where there is severe trauma and muscle spasm, a nuclear bone scan may be done to check if the pars defect is indeed a fracture. If so, it may be necessary to place the child in a rigid lumbosacral orthosis or even a body cast. Sports will be curtailed for 3 months to allow time for healing. In patients with spondylolisthesis, the treatment depends on several factors, depending on age, sex, and severity of slip. The younger child has a higher chance of further slip with growth.
Girls are more prone to progressive slip than boys.
Severity of slip is estimated on the lateral view on X-ray, and depends on the amount of contact left between the L5 and S1 vertebral bodies. The higher the grade of slip, the more serious the problem, and the higher the chances of further slip. A CT scan or even an MRI may sometimes be needed to further elucidate the bone and nerve problem before treatment is started. For Grades 1 and 2, conservative treatment is usually instituted. If the patient responds to conservative treatment, the pain resolves, the hamstring tightness improves, and the patient may return to limited sports.