What is the likely diagnosis for a 12-year-old male with back pain and recent bedwetting?

In a 12-year-old male presenting with back pain and recent bedwetting, the likely diagnosis is spondylolisthesis. This condition typically occurs when one vertebra slips forward over another, often in the lumbar spine, and is associated with instability and potential nerve compression.

The combination of back pain and new-onset bedwetting can signal that there is an underlying structural issue affecting the spine or the neurological pathways that control bladder function. Spondylolisthesis can lead to nerve root impingement, which may contribute to changes in urinary control, such as bedwetting.

This condition can arise from various causes, including sports-related injuries, congenital defects, or degenerative processes. In preadolescent children, it is often linked to stress fractures due to repetitive hyperextension activities, such as gymnastics or football.

While other conditions mentioned like disc herniation, osteomyelitis, and spinal stenosis can also lead to back pain, they typically do not present with urinary symptoms like bedwetting as prominently as spondylolisthesis does in this age group. Disc herniation often results in radicular pain without associated urinary symptoms, osteomyelitis usually comes with fever and signs of systemic infection, and