Spondylolisthesis
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Spondylolisthesis is the anterior displacement of one vertebra over another and is usually caused by the failure of anatomical structures like facets or the posterior bony arch. It is most commonly seen at L4-L5 and L5-S1 levels. Symptoms include axial pain, neurogenic claudication, and radiculopathy. Treatment depends on the degree of slip and presence of neurological symptoms, ranging from conservative management to surgical procedures like fusion either with or without instrumentation.
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Bhaskar Health News and Medical Education is leading source for trustworthy health, medical, science and technology news and information. Providing world health information Medical Education.
Bhaskar Health News and Medical Education is dedicated to medical students, physiotherapists, doctors, nurses, paramedics, physician associates, dentists, pharmacists, midwives and other healthcare professionals.
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Bhaskar Health News and Medical Education is leading source for trustworthy health, medical, science and technology news and information. Providing world health information Medical Education.
Bhaskar Health News and Medical Education is dedicated to medical students, physiotherapists, doctors, nurses, paramedics, physician associates, dentists, pharmacists, midwives and other healthcare professionals.
We're committed to being your source for expert health guidance. Bhaskar Health and Medical Education.
Source : https://www.bhaskarhealth.com
Health Shop: https://www.bhaskarhealth.org
@drrohitbhaskar @bhaskarhealth
#DrRohitBhaskar #BhaskarHealth
#Health #Medical #News #Physiotherapy
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This document discusses spondylolisthesis, including its anatomy, classification, natural history, and management. Some key points include:
- Spondylolisthesis is the forward translation of one vertebra on another, often caused by a defect in the pars interarticularis. It is classified by its cause and severity.
- Symptoms range from low back pain to neurological deficits depending on grade. Imaging helps assess severity and complications.
- Conservative care focuses on symptom relief but surgery may be needed for progressive slippage, deformity, or neurological problems.
- Surgical options include decompression with or without fusion to improve stability. Fusion techniques include posterolateral, anterior, or circumferential
Forearm And Elbow Pathologies Dr. Mark Davies Sjsu, Spring 2008
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Degenerative Spondylolisthesis
The document discusses degenerative spondylolisthesis, including its definition, classification, risk factors, clinical presentation, imaging findings, non-operative and operative treatment options, and guidelines for treatment. Key points include that it most commonly affects L4-L5, is more common in females, clinical symptoms do not always correlate with radiographic progression, non-operative treatment is usually initial approach, and decompression with fusion may improve outcomes over decompression alone for single-level disease.
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Low back pain is a common cause of disability that affects people of all cultures. It can be acute, lasting less than three months, or chronic, lasting over three months. Common causes include muscle strains, arthritis, herniated discs, and osteoporosis. Physical examination involves assessing range of motion, neurological function, and diagnostic tests like x-rays and MRIs. Physiotherapy management aims to reduce pain and inflammation, improve muscle strength and flexibility, and prevent recurrence through exercises and physical agents like ultrasound, TENS, and spinal traction.
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Current Concepts in Patellofemoral Pain Syndrome: Treatment and Rehabilitation by Dale J. Buchberger, MS, PT, DC, CSCS, DACBSP.Patellofemoral Mystery: Differential Diagnosis
What/Where is the true source of PFP?
What theories do we use for diagnosing PFP and how does literature support the theories?
How can we better treat “PFPS” patients through a more thorough evaluation and the developing classifications of PF disorders?
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Spondylolisthesis
- 1. Dr (Major) Parthasarathy S Pg Resident,MS Orthopaedics Stanley Medical College,Chennai Ref:Campbell’s operative orhopaedics 13th edition
- 2. Greek word Spondylo(spine) olisthesis(slip) First described by Herbinaux(Obstetrician) in 1782 Ant translation of cephalad vertebra relative to adjacent caudal vertebra
- 3. Anteriorely directed vector created by contraction of erector spinae muscle &force of gravity acting on upper body mass Not seen in children before ambulation Failure of anatomic structures Facets Posterior bony arch pedicles
- 5. Axial pain Neurogenic claudication Radiculopathy Cauda equina syndrome Sagittal imbalance Truncal shortening
- 6. Type VI,iatrogenic Most common type L4-5 L5-S1 level common
- 11. >25% threshold of signicant sacral deformity
- 12. SS+PT=PI
- 13. Slip angle >30 & lumbosacral angle >10 have predictive value for progression
- 14. LS spine X-ray AP Lat Lat flexion/extension Oblique if suspecting spondylolysis MRI SPECT HRCT
- 18. Absence of significant neurological deficit Translation <1-2mm Control acute sympoms then trunk stabilisation exercise & physiotherapy Epidural steroid Back pain not controlled in 6 months-surgery
- 19. Repair of pars interartcularis defect No spondylolisthesis No degenerative disc changes in that level No degenerative facet changes No dysplastic changes Method – pedicle screw fixation & bone grafting
- 20. Instrumented posterolateral fusion(wiltse & spencer) No significant neurological symptom Good spinal alignment Sufficient surface area >2cm2 of transverse process Less surface area for posterolateral fusion Posterior only approach with circumferential fusion(posteior/transforaminal lumbar interbody fusion PLIF/TLIF) Ant lumbar interbody fusion with post supplemental fixation Used if small transverse process Salvage procedure if non union in posterolateral fusion Patients with neurological symptom Direct/indirect decompression also needed
- 25. Lumbar decompression & posterolateral fusion with or without instrumentation PLIF/TLIF ALIF – failed posterolateral fusion/persistent instability Decompression alone Elderly Comorbidities
- 27. Pseudoarthrosis Persistent back pain >4-6 months Return of pain New/worsening neurologic symptom Persistent gait abnormality Most diagnostic Persistent lucent line at the fusion site Visible motion on dynamic radiograph Neurologic deficit Vascular complicatios Infection