Spondylothesis Repair

Spondylothesis Repair-71
Surgery is indicated if the slippage is greater than 50% or in cases of refractory symptoms or progressive neurologic deficit.

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.

Options for operative management include direct repair of the spondylolytic defect, fusion in situ, reduction and fusion, and vertebrectomy.

Ideally, repair of a pars defect is for young patients with spondylolysis but no spondylolisthesis.

Once asymptomatic, patients with grade 1 or less slippage may resume their activities as desired (as long as they remain pain free).

Continue to emphasize avoidance of aggravating factors, particularly those activities that involve repetitive hyperextension of the back.The desire to participate in a contact sport should not be the sole indication for a fusion.Decompression and fusion are typically performed in cases of dural sac compression with the presence of bowel or bladder dysfunction or significant motor deficits.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.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.Avoidance of heavy labor or any repetitive hyperextension continues to be important.An occupational therapist can assist by completing an ergonomic evaluation and assessing subsequent workstation modifications if needed to avoid unnecessary loading of the patient's lumbosacral spine.An occupational therapist can be very beneficial for those individuals who need instructions and compensatory strategies for activities of daily living.Restriction from sports and other activities that require repetitive hyperextension may be sufficient treatment in young athletes.

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Comments Spondylothesis Repair

  • Spondylolisthesi Causes, Symptoms, Treatments
    Reply

    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.…

  • Surgery for Spondylolisthesis - YouTube
    Reply

    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.…

  • Common Spondylolithesis Questions - SpineUniverse
    Reply

    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.…

  • Deciding on Surgery for Isthmic Spondylolisthesis
    Reply

    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…

  • Surgery for Spondylolisthesis - SpineUniverse
    Reply

    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.…

  • Surgery for Degenerative Spondylolisthesis - Spine-Health
    Reply

    Since degenerative spondylolisthesis is a condition that disproportionately affects individuals over age 60 or 65, the surgery does present some additional risk. Surgical risk is more directly related to the overall health of a patient and not his or her absolute age.…

  • Spondylolisthesis Treatment, Surgery & Symptoms Cleveland Clinic
    Reply

    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.…

  • Adult Spondylolisthesis in the Low Back - OrthoInfo - AAOS
    Reply

    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.…

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