ABSTRACT
Sir James Brailsford 1 (The Queen’s Hospital, London) discussed many deformities of the lumbosacral spine in a lengthy 1929 article. One of the conditions he elaborated on was spondylolisthesis. Regarding the antero-posterior radiographs he said, ‘These may be absolutely typical … It will be seen that the anterior border of the transverse process is continuous with the anterior border of the body. With a definite case of spondylolisthesis, the superior surface of the body of the 5th lumbar vertebra is facing forwards, and an anteroposterior radiograph of the patient will show the 5th lumbar body and transverse processes in this plane, and this characteristic outline [Figure 1] of the anterior border of the body and transverse processes will be projected against the shadow of the sacrum.’ He later used the term ‘bow sign’ to describe this appearance 2 . Other terms, more commonly used today, include the Napoleon hat sign or gendarme’s hat sign (the latter from Anne Brower, personal communication). Anteroposterior radiograph showing Napoleon-hat sign of spondylolisthesis. Case courtesy of Dr C. Resnik, University of Maryland https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9781003076568/34c29fd5-5662-4e8f-b58c-badd7fa5d724/content/fig58_1_B.jpg"/>
