1/7. Importance of correlating static and dynamic imaging studies in diagnosing degenerative lumbar spondylolisthesis.Degenerative spondylolisthesis in the lumbar spine is due to long-standing segmental instability. A standing plain radiograph is commonly the only imaging study needed to establish the diagnosis. Translatory motion in spondylolisthesis is traditionally assessed with lateral flexion and extension radiographs. These dynamic studies often demonstrate a decrease in the slip percentage between the vertebral segments with extension and an increase with forward flexion. Some low-grade spondylolisthetic deformities reduce anatomically on the operating table after the administration of an anesthetic. We encountered one case in which there was complete reduction of an L4-5 grade I degenerative spondylolisthesis with positioning of a non-anesthetized patient in the supine position during a lumbosacral magnetic resonance imaging (MRI) scan. The patient's condition was originally misdiagnosed, as the spondylolisthesis was not identified on recumbent plain radiographs or on lumbosacral MRI. This case stresses the importance of correlating static and dynamic imaging studies in developing a treatment plan for patients with degenerative spondylolisthesis.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
2/7. Disc herniation after lumbar fusion.STUDY DESIGN: Eight patients with a herniated disc after lumbar spinal fusion are reported. Their clinical features, imaging studies, and management are reported. OBJECTIVES: To identify the incidence and features of disc herniation above a spinal fusion, and to describe their management. SUMMARY OF BACKGROUND DATA: Late complications of lumbar spinal fusions have been reported in the literature, but disc herniation has not been specifically addressed in detail. The motion segment above a spinal fusion undergoes additional stresses, as documented by increased pressure and excessive motion, resulting in degenerative changes. These factors likely predispose to disc herniation. methods: Of 601 consecutive lumbar fusion cases over an 8-year period, herniated nucleus pulposus above the fusion was diagnosed in 8 patients. The clinical findings and imaging studies were reviewed, including a myelogram computed tomography scan, a magnetic resonance image with positive documentation of the herniation, or both. The management of these cases was reviewed. RESULTS: Eight patients (1.3%) (4 men and 4 women) were identified, whose average age was 56.4 years. Nonoperative treatment failed in six patients. Two of these patients underwent simple discectomy, and the remaining four underwent discectomy and fusion. All four patients went on to fusion. The average time from disc herniation onset to fusion was 28.4 months. CONCLUSIONS: Herniated disc after lumbar spinal fusion was found in approximately 1.3% of patients. Although rare, this entity that should be considered when patients complain of recurring back pain after a lumbar spinal fusion.- - - - - - - - - - ranking = 2keywords = motion (Clic here for more details about this article) |
3/7. Traumatic spondylolisthesis: a case report and review of the literature.A 30-yr-old male presented with severe neck pain and minimal range of motion. After previous diagnosis of cervical strain/sprain syndrome, careful orthopedic and neurological examination indicated a very serious problem. magnetic resonance imaging was ordered, revealing the presence of traumatic spondylolisthesis (hangman's fracture) with severe instability of C2 and C3.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
4/7. Cervical spondylolisthesis associated with the multiple nevoid basal cell carcinoma syndrome.Cervical spondylolisthesis is a rate vertebral anomaly that has not been associated with other major congenital abnormalities. In a 16-year-old girl, lower cervical spondylolisthesis was associated with a multiple nevoid basal cell carcinoma syndrome. The salient features of cervical spondylolisthesis include occipital headache, nuchal rigidity, torticollis, painful range of limited motion, hypesthesia, and depressed deep tendon reflexes. The treatment in the patient was anterior vertebral body fusion. awareness of this associated problem and prompt treatment are essential for prevention of neurologic loss.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
5/7. Modified repair of a defect in spondylolysis or minimal spondylolisthesis by pedicle screw, segmental wire fixation, and bone grafting.A surgical technique for treatment of spondylolysis or minimal isthmic spondylolisthesis is described. The authors based their treatment on the Scott technique, which involves placing an 18-gauge stainless steel wire around the transverse process bilaterally and then tightening the wires to each other inferiorly to the posterior spinal process. The modified technique consists of a tension band wire around the posterior spinous process and a 4.5 mm AO cortical screw in the pedicle. A case study of a 20-year old female athletic student is presented to illustrate the effectiveness of the modified technique. The authors believe that this technique offers the advantages of maintaining all motion segments and avoiding the risks of damaging the exciting nerve root just beneath the transverse process.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
6/7. Rigid intrasegmental fixation for repair of a pars defect in a young athlete: case report and description of technique.Stabilization for the treatment of a pars defect frequently involves fusion with sacrifice of a motion segment. Intrasegmental stabilization has been described, however, with preservation of the motion segment by using various constructs. We describe a method of obtaining rigid fixation across a pars defect without sacrificing a motion segment.- - - - - - - - - - ranking = 3keywords = motion (Clic here for more details about this article) |
7/7. Paradoxical motion in spondylolisthesis due to two-segment instability.We report here a paradoxical motion in unstable spondylolytic spondylolisthesis: a more forward displacement of the L5 vertebral body on the sacrum on the standing extension view than on the standing flexion view. An axial loading through the inferior articular process of the posteriorly displaced L4 on extension appears to be the cause, while the instability in the two contiguous segments may be an important contributing factor.- - - - - - - - - - ranking = 5keywords = motion (Clic here for more details about this article) |