Diagnosis and treatment of severe dysplastic spondylolisthesis.

Treatment for spondylolisthesis is based on the diagnosis made by collecting ..

“Diagnosis and treatment of severe dysplastic spondylolisthesis.”

Like isthmic spondylolisthesis, however, spondylolysis is amenable non-operative care; however, for those patients who are refractory to such care, surgical stabilization of the pars fractures may be required.

Spondylolisthesis Treatment, Surgery & Symptoms

If such a fracture is present in one or both of the pars interarticulari (plural), yet no slip has occurred, then the condition is called a spondylolysis (figure left), which can be just as painful and debilitating as a spondylolisthesis.

The most common symptom of spondylolysis is low back pain that is aggravated by motion at the waste—especially with sporting activity. Unlike isthmic spondylolisthesis, however, spondylolysis by itself does not typically cause concomitant (associated with) radicular pain or neurogenic claudication.


Spondylolisthesis - PhysioWorks

I shall not dive to deeply into the multifaceted subject of nonoperative care (conservative care); however, I will say that the lions' share of symptomatic isthmic spondylolisthesis and spondylolysis patients respond quite nicely to treatment interventions such as medication, bracing, physical therapy, low-force chiropractic care (never let your chiropractor perform a grade 5 spinal manipulation!), acupuncture, and home exercise. Injective treatments, such as epidural steroid injections (for lower extremity pain), and facet / pars injections (for low back pain) may also be effective if the other non-operative treatments fail.

What Causes a Spondylolisthesis

By this point, I bet many of you are wondering about the available treatment options for isthmic spondylolisthesis and spondylolysis. Therefore, let's talk about them.

Isthmic vs Degenerative Spondylolisthesis

Neurogenic claudication (a.k.a., neurogenic intermittent claudication) is one of the more severe complications of isthmic spondylolisthesis (or degenerative spondylolisthesis for that matter) and occurs after prolonged standing or walking. Specifically, the person will experience a progressive increase of lower extremity pain, cramping, and weakness following standing or walking, which is dramatically relieved by sitting down to rest or bending forward at the waist—like when you push a shopping cart {this is called "shopping cart sign"}). [63] this neurogenic intermittent claudication, unlike in central stenosis caused by degenerative spondylolisthesis, typically ONLY AFFECTS ONE LOWER EXTREMITY.

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On the other hand, increased age, lumbar lordosis, and BMI (how heavy you are) were all significantly related to the presence of degenerative spondylolisthesis. [59]

Spinal Surgery: Laminectomy and Fusion - Medical …

What causes the radicular pain? There are two causes: #1) the fracture site it self can produce a thickening which can irritate the exiting nerve root as it rounds the pedicle and passes near the fracture site. This "thickening" is called the beak of the spondylolisthesis/spondylolysis. #2) if there is a slip, then the superior articular process can slide forward and irritate the exiting nerve root in the lateral recess and/or proximal neuroforamen.