Congenital for Spondylolysis or Spondylolisthesis

If the pars "cracks" or fractures, the condition is called Spondylolysis. The x-ray confirms the bony abnormality. Treatment is customized based on the severity of symptoms. Anti-inflammatory drugs, physical therapy, brace wear, and activity modifications will be considered. core exercisesPrior to a release to activities after the pain resolves, a course of truncal core muscle strengthening (pilates or yoga) may be prescribed to condition the muscles and minimize reinjury.

Spondylolysis and spondylolisthesis - Mayfield Clinic

Repetitive trauma in clinical onset or aggravation of Spondylolisthesis and/or Spondylolysis

Spondylolysis and Spondylolisthesis of the Lumbar …

For posterior spinal decompression surgery to aggravate Spondylolysis or Spondylolisthesis, signs/symptoms of Spondylolysis or Spondylolisthesis should occur within 10 years of the surgery.

Spondylolysis & Spondylolisthesis - USC Spine

For posterior spinal decompression surgery to cause Spondylolysis or Spondylolisthesis, the surgery may occur any time before clinical onset of either condition.

For repetitive trauma to cause or aggravate Spondylolisthesis and/or Spondylolysis, the following should be evident:
spondylolysis: a spinal instability in which there is a weakness between the body of a vertebra and the pedicle.

Spondylolysis / Spondylolisthesis | UW Medicine

Debilitating pain - spondylysis - spondylolithesis 1. Pars fusion - painful spondylysis - minimal spondylolithesis 2. Fusion A. In situ v reduction - not required for grade 1 - 2 - consider if sagittal malalignment - associated with risk neurology especially L5 - controversial if should be performed in high grade slips B. Instrumented / non instrumented C. Levels - L5/S1 if grade I or II / 50% or less - L4/S1 if 50% for more D. Interbody cages - useful in long standing spondylolithesis presenting in adulthood - degenerative disc disease - nerve root pain from interforaminal compression - improves nerve root space - improves healing rate E. Posterior v circumferential - circumferential approaches may improve fusion rates and outcome in high grade slips Indication - normal discs and facets - pain relieved by pars injection - failure brace / non operative treatment - minimal slip Technique - lesion identified / debrided / iliac crest bone graft Options ORIF 1. Screw across lytic defect - unilateral defect 2. Pedicle screw + laminar hook - bilateral defect 3. TBW spinous process and transverse process Results Kakluchi et al JBJS Am 1997 - 16 patients with failure non operative treatment bilateral pars defect - pain relieved by pars injection with LA - pedicle screw + lamina hook - nerve root decompression where required - union in all 16 - 3 patients only had occasional back pain A. Wiltse Lateral Mass Fusion in situ Concept - in situ fusion via a paraspinal muscle splitting approach - no reduction or instrumentation Indication - for L5/S1 with minor slip in young patient - rarely done these days - most surgeons perform instrumented fusion Technique - midline incision - two paramedian incisions in lumbodorsal fascia 4.5cm lateral to midline - paraspinous muscle splitting approach 2 fingerbreadths lateral to midline - split sacrospinalis using finger to dissect through muscle - don't go anterior to TP or risk damage to nerve root - decorticate TP / Sacral ala / facet / famina and add crest graft / allograft / BMP Post-op - spica 3/12 with 1 leg incorporated - activity modification for 6/12 Instrumented fusion in situ without reduction Indications - slip grade 1 or II - grade III or IV with no sagittal malalignment Levels instrumentation - L5 / S1 grade I or II - L4 / S1 grade III or IV Options 1. Pedicle screw instrumentation 2. PLIF / interbody cage 3. Bohlman procedure - interbody fusion with fibula strut - augmented with decompression and PLF 4.

Spondylolysis, in the absence of spondylolisthesis, does not cause pathological changes in the disc, or neurological deficits.

Spondylolysis and Spondylolisthesis - Hospital for …

The initial treatment plan for spondylolysis is rest coupled with the use of anti-inflammatory medications. In some cases physical therapy and back bracing may be used as well.

A severe trauma to the vertebral spine in the clinical onset or aggravation of Spondylolysis or Spondylolisthesis

Spondylolysis / Spondylolisthesis

Spondylolisthesis is most often caused by spondylolysis. The cause of spondylolysis is not as clearly defined. Most believe it is due to a genetic weakness of the pars interarticularis. Both spondylolysis and spondylolisthesis can be present at birth or occur through injury. Repeated stress fractures caused by hyperextension of the back (as in gymnastics and football) and traumatic fractures are also causes. The most common cause in adults is degenerative arthritis.