Spondylolysis and spondylolisthesis: A review of the literature

Introduction: One of the most common types of spinal diseases is spondylolisthesis, which in advanced cases requires surgical intervention. This study aimed to compare the results of L4-L5-S1 and L5-S1 vertebral fusion treatment in high-grade L5-S1 spondylolisthesis. Methods: A study design that randomized controlled trial. A total of 70 consecutive patients who underwent surgery for the treatment of spondylolisthesis at Al-Zahra Hospital in Isfahan, Iran, were evaluated from July 2020 to February 2021 (35 patients underwent L4-L5-S1 and 35 received L5-S1 vertebral fusion treatment). The radicular and low back pain (LBP) intensity (Vanguard Australian Shares), blood loss, wound infection, reduction, and quality of life (SF-12 scores) were quantified before the surgery, 1, 3, and 6 months after surgery in two groups. Results: Patients involved in the two groups had similar baseline demographic characteristics. The percent slip in L4-L5-S1 and L5-S1 group, respectively, postoperative 81.11% and 57.89%, P = 0.0001. Intraoperative blood loss and postoperative were higher in the L4-L5-S1 group when compared to the L5-S1 group ( P < 0.05). The wound infection rate of the L4-L5-S1 group was similar to that of the L5-S1 group (8.6% vs. 2.9%, P = 0.303). There was no difference in radicular and LBP intensity, SF-12 scores among patients with L4-L5-S1 and L5-S1 groups ( P < 0.05). Conclusion: Both L4-L5-S1 and L5-S1 were equally beneficial in improving short-term functional outcomes for patients with high grade L5-S1 spondylolisthesis. However, L4-L5-S1 was associated with statistically significant higher incidences of blood loss, but it was accompanied by a better reduction. Therefore, caution should be exercised when considering L4-L5-S1.

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“…It occurs at the L5 vertebrae between 85% and 95% of the time and occurs at the L4 vertebrae 5%–15% of the time. [ 7 ]…”

Section: Introductionmentioning

confidence: 99%

A comparative study of L4-L5-S1 and L5-S1 vertebral fusion in high-grade L5-S1 spondylolisthesis

Rezvani¹,

Saboori²,

Mahmoodkhani³

et al. 2021

Journal of Craniovertebral Junction and Spine

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“…The most common presenting symptom of spondylolisthesis is back pain, with or without radiculopathy typically affecting the L5 nerve root dermatome (1). Spondylolisthesis can be visualized with most radiologic modalities, including plain radiograph, computerized tomography (CT), magnetic resonance imaging (MRI), and even ultrasound.…”

Section: Introductionmentioning

confidence: 99%

Overreporting of the disc herniation in lumbar spine MRI scans performed for patients with spondylolisthesis

et al. 2020

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Background Spondylolisthesis is often misdiagnosed on magnetic resonance imaging (MRI) as the slip may reduce to a normal alignment when the patient lies supine. Often, disc herniation is reported at the level of spondylolisthesis. Purpose To determine the incidence rates of disc herniation at the level of spondylolisthesis. Material and Methods This is a retrospective study included 258 consecutive patients with spondylolisthesis who had lumbar spine MRI. The archived reports were collectively put in Group 1. A musculoskeletal radiologist and a spine surgeon reviewed the imaging studies together. Their readings were referred to as Group 2. The findings of both groups were compared to evaluate whether disc herniation was overreported. Results Group 1 reported findings of true disc herniation in 112 (41.6%) cases and pseudo disc herniation or no findings of disc herniation at the level of spondylolisthesis in 157 (58.4%) cases. Group 2 reported findings of a true disc herniation in 25 (9.3%) cases and pseudo disc herniation or no findings of disc herniation in the remaining 244 (90.7%) cases. There was a statistically significant difference in the reporting rates between these two groups ( P < 0.02). The most overreported finding was the disc bulging ( P < 0.01). Conclusion The current study showed overreporting of disc herniation in lumbar spine MRI scans performed for patients with established spondylolisthesis. The majority of disc pathology at the level of spondylolisthesis are pseudo disc rather than a true disc herniation. An accurate diagnosis is vital in planning surgical intervention.

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“…One of the most common musculoskeletal diagnoses of adolescent low back pain is spondylolysis. Spondylolysis is a generally well‐recognized condition with classic history and specific vertebral pathology on imaging with a standard treatment algorithm . A lesser known cause of back pain with similar presenting history is posterior vertebral endplate fracture (PVEF), also known as posterior rim apophysis or limbus fracture .…”

Section: Introductionmentioning

confidence: 99%

Posterior Vertebral Endplate Fractures: A Retrospective Study on a Rare Etiology of Back Pain in Youth and Young Adults

Conlee

Driscoll

Wood

et al. 2019

PM&R

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Background: Posterior lumbar vertebral endplate fracture occurs with avulsion of the ring apophysis from the posterior vertebral body. Although this has been described in adolescents and young adults, proper diagnosis is often delayed or missed entirely. Surgery may be curative. Objective: To determine the common clinical features and treatment outcomes in youth and young adults with posterior lumbar vertebral endplate fractures. Design: Retrospective case series. Setting: Academic medical institution. Patients: Patients 10 to 25 years old from 2000 through 2012 with posterior vertebral endplate fracture diagnosis. Main Outcome Measurements: Demographic characteristics, diagnostic studies, interventions, and change in symptoms postoperatively.Results: A total of 16 patients had posterior vertebral endplate fractures (8 male patients; mean age, 15.2 years)-8.3% of 192 patients with inclusion age range undergoing spinal surgery for causes unrelated to trauma, scoliosis, or malignancy. The most common signs and symptoms were low back and radiating leg pain, positive straight leg raise, hamstring contracture, and abnormal gait. Cause was sports related for 12 patients (75%). Mean (range) time to diagnosis was 13.0 (3.0-63.0) months. Diagnosis was most commonly made with lumbar magnetic resonance imaging (n = 6). Most fractures occurred at L5 (n = 8, 50%) and L4 (n = 5, 31.3%). Conservative measures were trialed before surgery. Nine patients had "complete relief" following surgery and seven "improved." Conclusions: Posterior vertebral endplate fracture should be considered in differential diagnosis of a youth or young adult with back pain, radiating leg pain, and limited knee extension, regardless of symptom onset. For patients in whom conservative management fails, consultation with an experienced physician whose practice specializes in spine medicine is recommended.

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Spondylolysis and spondylolisthesis: A review of the literature

Cited by 75 publications

References 59 publications

A comparative study of L4-L5-S1 and L5-S1 vertebral fusion in high-grade L5-S1 spondylolisthesis

A comparative study of L4-L5-S1 and L5-S1 vertebral fusion in high-grade L5-S1 spondylolisthesis

Overreporting of the disc herniation in lumbar spine MRI scans performed for patients with spondylolisthesis

Posterior Vertebral Endplate Fractures: A Retrospective Study on a Rare Etiology of Back Pain in Youth and Young Adults

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