Spondylolisthesis

MRI Spondylolisthesis

Spondylolisthesis (olisthesis = displacement, slippage) is a sagittal displacement of a vertebra forward in relation to the adjacent, lower one. It occurs most often in the lumbosacral region of the spine. The cause is impaired development (ossification) of the arch, or permanent micro-traumatization and subsequent disruption of the isthmus – spondylolysis – so-called isthmic spondylolisthesis (most often L5–S1), or as a result of instability in older patients – degenerative spondylolisthesis, typically L4–5, and rarely trauma. inflammation or tumor.

Clinical picture

• pain in the lumbar region;
• propagation of pain to the buttocks and lower limbs (hip joints, outer and inner thighs);
• root irritation; radicular and pseudoradicular irritation
• neurogenic claudication;
• momentum limitation.

Spondylolisthesis of the lumbar region on the skiagram

Diagnostics

• history, clinical picture;
• palpation;
• a characteristic image on a radiograph. Size of displacement: expressed in % displacement of the 1st vertebra compared to the 2nd on the lateral X-ray image, grade I–IV;
• dynamic X-ray image (in forward and backward tilt);
• addition: MR, CT event. PMG.

Therapy

1. Conservative;
   • medical rehabilitation for muscle strengthening;
   • orthopedic aids (corset).
2. Surgical;
   • indication: long-term failure of conservative therapy, development of neurological deficit due to narrowing of the spinal canal or progression of vertebral slippage
   • procedures combining decompression of the spinal canal with subsequent vertebra reduction + stabilization (spondylodesis)

Links

Related articles

• Lower back pain, Lumbago
• Lumbar intervertebral disc herniation
• Lumbar spinal canal stenosis
• Syndroma caudae equinae

References

• SAMEŠ, M. Neurochirurgie. 1. edition. Jessenius Maxdorf, 2005. 127 pp. pp. 93. ISBN 80-7345-072-0.

• VOKURKA, Martin. Velký lékařský slovník. 7. edition. Maxdorf, 2007. pp. 897. ISBN 978-80-7345-130-1.