Spondylolisthesis

[steve87]

Recently I applied for the Marine Corps Platoon Leader's Class. In the process when I went to MEPS the doctors found a problem with my back called spondylolistesis. This was a suprise for me because I have never had any problems with my back and I am a very physically active person. Consequently, I was not accepted into the Marines whatsoever. On the other hand I was able to get a wavier from the Navy.
The question I have is if anyone has ever heard of this condition and if it is a disqualifying factor for Navy SEALs. I understand that this condition is a slippage of the vertebrae between L5 and S1.
Thanks

[lisalynne10]

Recently I applied for the Marine Corps Platoon Leader's Class. In the process when I went to MEPS the doctors found a problem with my back called spondylolistesis. This was a suprise for me because I have never had any problems with my back and I am a very physically active person. Consequently, I was not accepted into the Marines whatsoever. On the other hand I was able to get a wavier from the Navy.
The question I have is if anyone has ever heard of this condition and if it is a disqualifying factor for Navy SEALs. I understand that this condition is a slippage of the vertebrae between L5 and S1.
Thanks


Gresham? As in Oregon??? Just wondering.

Sorry, but I cannot answer as to whether or not it's disqualifying for SEALs. All I do know is that it can be a birth defect or usually it's a degenerative disease. You're correct in that it's between L5and S1, primarily happening in L4 or L5. Good luck to you!

[dive doc]

Recently I applied for the Marine Corps Platoon Leader's Class. In the process when I went to MEPS the doctors found a problem with my back called spondylolistesis. This was a suprise for me because I have never had any problems with my back and I am a very physically active person. Consequently, I was not accepted into the Marines whatsoever. On the other hand I was able to get a wavier from the Navy.
The question I have is if anyone has ever heard of this condition and if it is a disqualifying factor for Navy SEALs. I understand that this condition is a slippage of the vertebrae between L5 and S1.
Thanks

Steve,

im not sure about spon and DQ, the Navy and Marine Corps etc, ill see if i can find anything out. Somebody else be able to contribute here. If you have not suffered any kind of traumatic back injury in the past then it is probable that it is congenital spondylolisthesis. I have just added some general info below that you may find helpful to refere to.

DD

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The word spondylolisthesis is derived from the Greek words spondylo meaning spine and listhesis meaning to slip or slide. Spondylolisthesis is a descriptive term referring to slippage (usually forward) of a vertebra and the spine above it relative to the vertebra below.

Spondylolisthesis has many etiologies, all of which ultimately lead to a loss of the stability offered by the locking mechanism of the articular processes of the vertebrae that allow the superior vertebrae to slide forward over the inferior vertebrae. The etiologies can be classified as congenital (dysplastic), spondylolytic (isthmic), degenerative, traumatic, pathologic, or iatrogenic (eg, postoperative).

A working knowledge of normal anatomy and the locking mechanism is helpful in understanding how and where the mechanism can fail.

In the healthy person, the facet joint in the lumbar spine is, for the most part, in the coronal plane, with the inferior articular process of the superior vertebra located posteriorly and the superior articular process of the inferior vertebra located anteriorly. This configuration prevents forward movement of the vertebrae relative to each other. It locks in the superior vertebra relative to the inferior vertebra. This mechanism is important because the center of gravity of the human body is located anterior to the spine and exerts a forward slipping force on the spine, especially at the L5-S1 level. Furthermore, the anteriorly located center of gravity causes a rotating movement, with the axis of rotation oriented transversely at the L5-S1 level. Thus, in severe spondylolisthesis, a kyphotic deformity also develops.

Simplistically, a vertebra (and the spine above it) may slip if abnormalities are present within the facets and facet joints, articular processes, or neural arch (ie, connection between the facet joints and the vertebral body). Various etiologies affect one or more locations.
In the congenital (dysplastic) type, congenital anomalies of the vertebral arch and/or facets occur at the lumbosacral junction. Spondylolysis is excluded, as patients are not born with that lesion. Lesions in this category include dysplastic facets that may have an axial (horizontal) orientation, sagittal orientation, or some other cause, such as failure of vertebral body formation. The end result is that the facets do not lock in, and forward slippage is allowed. The pars may remain intact, develop poorly, elongate, or even lyse. Note that when an intact posterior arch accompanies forward slippage, potential exists for the arch to impinge on the cauda equina. Alternatively, spondylolisthesis of the L5 vertebra may cause S1 nerve root compression by the L5 vertebra inferior articular process.

The female-to-male predominance is 2:1. This type accounts for approximately 15-20% of cases of spondylolisthesis. Symptoms usually develop during the adolescent growth period. The facet joint is a synovial joint and is subject to the same osteoarthritic changes that affect other synovial joints in the body. Thus, loss of hyaline cartilage (which is eburnation of the joint surface) and reactive hypertrophic bony changes can lead to altered alignment of the facet joint allowing spondylolisthesis.

[dive doc]

Steve,

the following is from the U.S. Navy Aeromedical Reference and Waiver Guide for Orthopedics

13.10 SPONDYLOLISTHESIS

AEROMEDICAL CONCERNS: Spondylolisthesis is unlikely to cause incapacitation in flight but, if symptomatic, will cause considerable distraction. Theoretically, spondylolisthesis could cause severe problems on ejection.

WAIVER: CD with no waiver for non-designated personnel. For designated personnel, asymptomatic grade I spondylolisthesis is CD but may be considered for a waiver. Higher grades of spondylolisthesis or symptomatic grade I sponylolisthesis are also CD, but waivers may be considered on an individual basis. Patients who have had successful surgery and are currently asymptomatic may also be considered for waiver on a case by case basis.

INFORMATION REQUIRED:
1. Orthopedic consult
2. Neurology consult
3. Rheumatology consult
4. OMT/Manual medicine consult (if available)

TREATMENT: Treatment includes education in proper body mechanics and use of the back, along with a program of daily back exercises.

DISCUSSION: Aircrew who has frequent symptoms should not continue to fly. Further slipping of the vertebra (usually L5) can occur with exposure to excessive gravitational forces, ejection, or even during normal activities on the ground. Aviators with infrequent symptoms who do not require surgery may still be restricted from ejection seat aircraft or carrier catapult launches and traps.

[steve87]

yea, I used to live in Gresham, OR. . .

[steve87]

Thanks div doc,
That helped a lot! When I initially applied for Marine PLC I applied for an Air contract so obviously that condition is a big deal for people who might have to punch out of an airplane. I don't want to be a hunchback for the rest of my life anyway.

steve

[k5]

I wrote about this in another thread. First, I can not even begin to answer the question of how it will impact the Navy or the BUD/S Seal program. I can speak from experience both personally and from my profession (sports medicine). Many people have spondylolisthesis and don't even know it ... yours truly as an example. I found out about mine (and my L4-5 disc bulge) while getting a CT scan for another issue. It certainly goes along way to explaining why I am as flexible as a 2x4 in the morning. Exercise and simply getting moving is all it takes to make me feel better! By the way I have a grade I-II spondy which means my L 4 has slipped between 25-50% of it's width over the L5 vertebra.

If I were a betting guy I'd put money down that of all the guys who finish out BUD/S all the way 25-33% will have either some evidence of slippage or of stress reaction/fracture in their backs.

Because the slippage is often found as incidental to imaging for another reason and that if asymptomatic it really doesn't impact one's ability to do active stuff I am surprised the Marines have an issue with this .... then again I don't know squat about how the military works.

[infantry_scout]

Not trying to hijack, but I grew up in Grants Pass, OR and lived in Portland for awhile, before moving to Washington. So I am VERY familiar with Gresham....small world. Oh yeah, and I have this condition too (I'm pretty sure)