Passive lumbar extension test is classically used in the diagnosis of which condition?

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Extending the lumbar spine dynamically reveals instability from forward vertebral slip. In spondylolisthesis, a pars defect lets a vertebral body slide forward relative to the bone below. When the patient is passively extended, the spine moves into a position that increases anterior shear at the slipped segment, often reproduced pain and sometimes nerve-related symptoms. That provocative extension effect is what makes this test classically used for diagnosing spondylolisthesis. While other conditions such as facet joint pain can also worsen with extension, the specific pattern of symptoms reproduced by a passive extension maneuver points most clearly to a slipping vertebra rather than radiculopathy or isolated facet pathology.