Lumbar Spine
Harry Griffiths in Musculoskeletal Radiology, 2008
The word “spondylolisthesis” comes from the Greek “spond” (spine) and “olisthesis” (to slip) and refers to the slippage of one vertebral body anteriorly on the one below. The term “retrolisthesis” has been used for the reverse situation, with the vertebral body above slipping posteriorly on the one below, but I do not like this term and use spondylolisthesis for all types of vertebral slips. Spondylolisthesis was first described by Herbiniaux in Belgium in 1782, but it was not until 1854 that Kilian discussed spondylolisthesis in any detail. It only occurs in humans and is presumably related in some way to our upright posture. The incidence of spondylolisthesis in the general population varies according to various authors; 4% to 5% is a reasonable figure (Fig. 8).
Physical Therapy and Pain Management
Mark V. Boswell, B. Eliot Cole in Weiner's Pain Management, 2005
To use the gym ball, patients must find a functional position of the spine, described as the most stable and asymptomatic position for the task at hand. Patients are trained to stay in this midrange of lumbo pelvic motion, also known as a neutral position. However, variation may occur based on the underlying pathology. Conditions such as spinal stenosis or spondylolisthesis may prevent patients from assuming this mid-range pain-free position. Dynamic stabilization is a complex neuromuscular skill in which a more neutral spine position is maintained by continuous fine adjustments in muscle tension in response to fluctuating loads. The patient must master the functional position and lumbar stability before starting a gym ball program. The gym ball must not reproduce the pattern that initially brought the patient in for treatment. The intensity of the program should be to the point of fatigue, almost losing control of the quality of moment or functional position, but not actually losing control. Quality of movement is more important than quantity of movement.
General principles of management of upper motor neuron paralysis
Benjamin Joseph, Selvadurai Nayagam, Randall Loder, Ian Torode in Paediatric Orthopaedics, 2016
Selective division of posterior rootlets that carry afferent impulses from spastic muscles has been shown to reduce spasticity.14 This method entails a lumbar laminectomy which may increase susceptibility to developing spinal deformities and spondylolisthesis.15,16 A long-term study reported that the reduction in spasticity and functional improvement was maintained 20 years after the procedure17 though the results appear to be less promising in the longterm in children over the age of 10 at the time of surgery.18
Intrathecal drug delivery for pain management: recent advances and future developments
Published in Expert Opinion on Drug Delivery, 2019
Sameer Jain, Mark Malinowski, Pooja Chopra, Vishal Varshney, Timothy R. Deer
Indications for use of intrathecal drug delivery systems in chronic pain management may further be divided into cancer-related pain and non-cancer related pain. The majority of patients selected for this therapy for non-cancer-related pain usually have spine pathologies as the source of their pain. These conditions may include, but are not limited to, compression fractures, spondylolisthesis, spondylosis, failed back surgery syndrome, and spinal stenosis. Patients that are considered for this therapy must have chronic intractable pain that is refractory to conservative and other less invasive interventional pain procedures [42]. Other non-cancer-related pain conditions that are being treated by IDDS include complex regional pain syndrome, pelvic pain, and abdominal pain as these conditions are usually refractory to other treatment modalities [43].
Sacral insufficiency fracture after lumbosacral decompression and fusion
Published in Baylor University Medical Center Proceedings, 2022
Brendan M. Holderread, Caleb P. Shin, Ishaq Y. Syed, Ioannis Avramis, James M. Rizkalla
Meredith et al4 recommended iliosacral fixation as prophylaxis when considering the risk of SIF, emphasizing the importance of pelvic incidence. (High pelvic incidence increases the risk of sacral fracture after lumbosacral fusion.) Buell et al7 recommended beginning management conservatively, with indications for revision surgery including pain refractory to nonoperative management, presence of a neurological deficit, nonunion with anterolisthesis, L5–S1 pseudoarthrosis, and misalignment of the spinopelvic axis. When considering surgical planning, the authors also recommended iliac screws. They stated that patients at increased risk of SIF identified preoperatively may receive prophylactic iliac screws at the initial surgery. Of the four operative cases in this series, none received prophylactic lumbopelvic fixation or iliac screws as part of salvage therapy. Two patients developed infection as a result of revision surgery and had complicated courses as a result. The two surgical cases without infection were managed with lumbopelvic fixation and returned to ambulate at their baseline. The patients managed nonoperatively with lumbar bracing, bone stimulator, or standard postoperative rehabilitation were all ambulating at their baseline with no symptoms within a year of their revision surgery.
Device profile of the FlareHawk interbody fusion system, an endplate-conforming multi-planar expandable lumbar interbody fusion cage
Published in Expert Review of Medical Devices, 2023
Peter B. Derman, Rachelle Yusufbekov, Brian Braaksma
These devices are cleared for use with autogenous bone graft and/or allogenic bone graft (cancellous and/or corticocancellous bone) in skeletally mature patients with degenerative disc disease (DDD) at one or two contiguous levels from L2-S1. DDD is defined as discogenic back pain with disc degeneration confirmed by history and radiographic studies. Patients may have up to Grade 1 spondylolisthesis or retrolisthesis at the surgical level(s) and should have undergone at least six months of non-surgical treatment. FlareHawk and TiHawk implants are intended to be used with supplemental fixation instrumentation and not in a stand-alone manner, reference cleared indications for use.
Related Knowledge Centers
- Vertebra
- Sacrum
- Lumbar Vertebrae
- Retrolisthesis
- Hangman'S Fracture
- Cervical Vertebrae
- Facet Joint
- Arthritis
- Ligamenta Flava
- Pars Interarticularis