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Spondylolisthesis is the displacement of vertebrae along with the entire stretch of vertebrae that lie higher in front of the vertebrae below. In other words, it is the movement of the vertebrae of the spine in relation to each other.
Spondylolisthesis – how does it arise?
Spondylolisthesis arises due to the existence of a vertebral arch fissure at the junction of the upper and lower articular processes. It most often occurs in the lower section of the lumbar spine L5-S1 and L4-L5. It can arise as a result of a direct spinal injury, e.g. a fall, have a dysplastic (i.e. congenital defect in the vertebral joints and arches), nodal (tearing the nodal nodes of the vertebral arch, i.e. spondylolysis) grounds, or be due to degenerative changes in the spine joints. Spondylolisthesis it is often confused with the sublimus (retrolisthesis), in which the vertebra curls backwards.
The disease can develop in children, adolescents and the elderly.
Spondylolisthesis – symptoms
Spondylolisthesis in the initial stage, it is manifested by pains radiating to the lower limbs, intensifying when sitting down and standing up, leg fatigue and discomfort. In later stages, there are difficulties in the patient’s movement, due to the pressure on the nerve roots, problems with urinary incontinence and paresis may appear.
In order to organize the degree of advancement spondylolisthesis, a special Meyerding classification is used:
- stage I – an offset of less than 25 percent;
- stage II – shift within 25-50 percent;
- stage III – shift within 50-75 percent;
- stage IV – shift of more than 75 percent;
- total spondylolisthesis – loss of vertebral contact.
Spondylolisthesis – treatment
In order to establish the appropriate treatment, imaging tests are necessary – X-ray, magnetic resonance imaging, computed tomography. Conservative treatment is sufficient for grade 1 and 2. It usually consists in immobilizing the patient in bed and applying appropriate medications to reduce the pain caused by spondylolisthesisas well as relax the muscles and have anti-inflammatory properties. Conservative treatment lasts up to 3 months. If the pain subsides, the patient must wear an orthopedic shoelace and perform the exercises determined by the physiotherapist for spondylolisthesis. Percutaneous transpedicular stabilization can also be used.
If pain persists, removal is necessary spondylolisthesis operation. It is also necessary for the higher Meyerding grades. The treatment is selected individually – the factors influencing its type include: age and health status and presence of neurological symptoms. Most often performed on spondylolisthesis operations are:
- local stabilization;
- spondylodesis without spondylolisthesis – used only for small spondylolisthesis;
- knot reconstruction – used for minor slips and in the presence of spine;
- spondylolisthesis reposition and spondylodesis – used in the case of major slips (XNUMXrd, XNUMXth degree) with a significant narrowing of the spinal canal;
- L5 vertebrectomy – anterior excision of the vertebra with simultaneous L4 / S1 anastomosis.
Spondylolisthesis and disability
If spondylolisthesis prevents work, and as a result of postoperative complications, it is possible to apply for a degree of disability and a pension on the basis of this title.