Spondylothesis Repair

Spondylothesis Repair-44
Surgery is indicated for skeletally immature patients with greater than 30-50% slippage (with or without symptoms) because they are at greater risk for progression, in the event of progressive neurologic deficit, or in those with pain persisting for more than 6-12 months that has not been relieved with rest and immobilization with any degree of slip.Spondylolysis or low-grade spondylolisthesis may be managed nonoperatively.

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Best results are observed in those with a lytic defect between L1 and L4. Disc degeneration as seen on MRI is a relative contraindication.

Slippage of greater than 2 mm decreases the likelihood of successful repair.

The postoperative rate of permanent neurologic deficits is high (25-30%), although many are preexistent.

This does not appear to be balanced by improved results; fusion in situ has achieved similar clinical outcomes with a lower complication rate.

This consists of exercises to strengthen the abdominal muscles (eg, William flexion-type exercises) and flexibility programs to stretch the spinal extensor muscles, hamstrings, and lumbodorsal fascia.

Avoidance of heavy-duty labor or activities with repetitive lumbar extension is necessary to allow healing to occur.

Patients with grade 2 slippage are generally instructed to avoid hyperextension loading of the spine after symptoms resolve with conservative treatment.

Younger patients require more careful observation, even if the initial symptoms resolve, because of their greater risk for progression.

In an asymptomatic child with slippage up to 25% (grade 1), initially observe with radiographs every 4-6 months if younger than age 10 years, semiannually until age 15 years, then annually until the end of growth.

No limitation of activities is required, but the patient is advised to avoid occupations that entail heavy labor.

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Comments Spondylothesis Repair

  • Surgery for Spondylolisthesis - YouTube
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    Education video on Surgery for Spondylolisthesis by Dr. Gary Simonds at Carilion Clinic. Education video on Surgery for Spondylolisthesis by Dr. Gary Simonds at Carilion Clinic.…

  • Adult Spondylolisthesis in the Low Back - OrthoInfo - AAOS
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    Spondylolytic Spondylolisthesis. One of the bones in your lower back can break and this can cause a vertebra to slip forward. The break most often occurs in the area of your lumbar spine called the pars interarticularis. In most cases of spondylolytic spondylolisthesis, the pars fracture occurs during adolescence and goes unnoticed until adulthood.…

  • Common Spondylolithesis Questions - SpineUniverse
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    A spondylolisthesis is a forward slip of one vertebra over the one beneath it. Spondylolisthesis occurs most often in the lumbar low back spine. There are several types of spondylolisthesis, such as congenital, developmental, and acquired. Some people are born with a thin vertebral bone called the.…

  • Surgery for Spondylolisthesis - SpineUniverse
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    Spine surgery for spondylolisthesis is a much-debated topic. While most surgeons agree that decompression of the nerves may benefit the patient, the question is whether the slipped vertebra needs to be realigned at all. It depends on what caused the spondylolisthesis. However, for other types of.…

  • Spondylolisthesis, Spondylolysis, and Spondylosis Treatment.
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    Spondylolisthesis refers to the forward slippage of one vertebral body with respect to the one beneath it. This most commonly occurs at the lumbosacral junction with L5 slipping over S1, but it can occur at higher levels as well.…

  • Spondylolisthesi Causes, Symptoms, Treatments
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    Spondylolisthesis is a slipping of vertebra that occurs, in most cases, at the base of the spine. Spondylolysis, which is a defect or fracture of one or both wing-shaped parts of a vertebra, can.…

  • Spondylolisthesis Treatment, Surgery & Symptoms Cleveland Clinic
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    Spondylolisthesis is a condition in which one of the vertebrae slips out of place onto the bone below it. Some people have no symptoms, but low back pain is the most common symptom if symptoms exist.…

  • Spondylolisthesis Treatment, Surgery & Symptoms
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    The type of surgery is based on the type of spondylolisthesis. Patients with isthmic spondylolisthesis may benefit from a repair of the defective portion of the vertebra, or a pars repair. If an MRI scan or PET scan shows that the bone is active at the site of the defect, it is more likely to heal with a pars repair.…

  • Deciding on Surgery for Isthmic Spondylolisthesis
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    In some cases, repair of the bone defect may be considered without fusion of the motion segment if there is no nerve compression or significant disc degenerative changes. Read more Spinal Fusion Surgery for Isthmic Spondylolisthesis…