A 45-year-old presents with low back pain and Grade II spondylolisthesis at L4–L5 (Meyerding classification). Meyerding Grade II specifically means the slip is:

• A 0–25% slip of superior vertebra on inferior
• B 51–75% slip
• C >75% slip (spondyloptosis)
• D 26–50% slip ✓

Explanation

The Meyerding classification of spondylolisthesis grades the anterior displacement of the superior vertebra over the inferior: Grade I 0–25%, Grade II 26–50%, Grade III 51–75%, Grade IV 76–100%, and Grade V (spondyloptosis) >100% where the vertebra has fallen off the sacrum entirely. Grade II (26–50%) is moderate slippage. Most symptomatic patients with Grades I–II are managed conservatively. Grades III–IV with neurological deficit or progressive slip typically require surgical stabilization (posterior instrumented fusion ± reduction). Isthmic spondylolisthesis at L5–S1 is the most common type requiring surgery.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

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Written and medically reviewed by the StethoPrep medical team.