1/3. Management of multiple level spondylolysis of the lumbar spine in young males: a report of six cases.The most common procedure for surgical treatment of lumbar spondylolysis is intertransverse processes spinal arthrodesis with instrumentation. However, this procedure is associated with significant morbidity on long-term follow up. Direct repair of spondylolysis is an alternative method for preservation of motion segment and anatomic continuity in young adults with multiple level spondylolysis. From 1992 through 1998, six soldiers with a diagnosis of multiple level spondylolysis who complained of persistent low back pain were treated in our hospital. spondylolysis involved two levels in five cases and three levels in one case. All patients underwent serial roentgenography of the lumbar spine and a staged pars interarticularis infiltration test with bupivacain 0.5%. Five patients underwent direct repair of the pars interarticularis defects with hook screws, translaminar screws, and bone graft, while one patient received conservative treatment. All surgically treated patients had either good or excellent results at a mean of 34.4 months follow-up. One patient who was treated nonsurgically still complained of sport restriction at 16 months follow-up. Direct repair of multiple pars interarticularis defects after a positive staged pars infiltration test can restore anatomic stability, relieve back pain, and preserve a greater range of motion of the lumbar spine in young patients with intact disc height.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
2/3. 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 = 0.5keywords = motion (Clic here for more details about this article) |
3/3. 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 = 2.5keywords = motion (Clic here for more details about this article) |