Diagnosis and conservative management of degenerative lumbar spondylolisthesis

Kalichman, Leonid; Hunter, David J.

doi:10.1007/s00586-007-0543-3

Cited by 174 publications

(144 citation statements)

References 54 publications

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“…This traditional approach is more prone to bias than a metaanalysis or systematic review; however, we endeavored to unreservedly include all studies. Such an approach has been successfully used before also in other topics [21,31,50]. Moreover, studies of intramedullary astrocytoma report patient characteristics and results in a very varying fashion, practically precluding a meta-analysis or systematic review.…”

Section: Methodsmentioning

confidence: 99%

Prognostic factors in intramedullary astrocytomas: a literature review

2009

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Astrocytomas affect a significant portion of patients with intramedullary tumors. These infiltratively growing tumors are treated by a variety of methods-biopsy and decompressive surgery, maximal safe resection, adjuvant oncological therapy. Also, numerous prognostic factors are reported in the literature. Better understanding of factors that influence prognosis may help in treatment planning with the goal of prolonging survival. We have thus undertaken an extensive literature review in order to define factors affecting prognosis. A total of 38 articles were studied. Only tumor grade was consistently reported as the major factor affecting prognosis. The influence of other clinical factors (age, gender, history length, functional status, tumor location or extent, syrinx or cyst presence) can be speculated upon, but cannot be assessed adequately from the available literature. For both low-and high-grade (HG) astrocytomas, maximal safe tumor resection should be the primary treatment objective but is often not feasible in contrast to other intramedullary and spinal neoplasms. Since the biological nature of spinal cord HG glioma is identical to that of the brain, the same treatment algorithm of maximal safe resection followed by concomitant radio-and chemotherapy would be sensible to implement.

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Section: Methodsmentioning

confidence: 99%

Prognostic factors in intramedullary astrocytomas: a literature review

2009

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“…However, those who suffer from neurological symptoms, such as intermittent claudication or vesicorectal disorder, will most probably experience neurological deterioration if they are not operated. [3] Treatment of this pathology has evolved over the past 20 years with the publication of numerous prospective randomized trials assessing the influence of fusion and instrumentation following decompression. Recently, soft-tissue stabilization devic- Eylül -September 2011…”

Section: Discussionmentioning

confidence: 99%

“…Lumbar DS is a major cause of spinal canal stenosis and is often related to low back and leg pain. [2][3][4] The aim of this paper was to emphasize the importance of spondylolisthesis mimicking the progression of dissection in the differential diagnosis of a chronic type B aortic dissection case.…”

mentioning

confidence: 99%

Spondylolisthesis mimicking the progression of dissection in a case of chronic Stanford type B aortic dissection

Göz¹,

Torun²,

Mordeniz³

et al. 2011

Ulus Travma Acil Cerrahi Derg

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Aort diseksiyonu akut ve ölümcül olan kardiyovasküler bir durumdur. Altmış yedi yaşında hipertansif kadın hasta, ani başlayan, bıçak saplanır tarzında alt sırt ağrısı nedeniyle, acil servise geldi. Kontrastlı toraks tomografisinde kronik Tip-B aort diseksiyonu tanısı konuldu. Yoğun bakı-ma transfer edilen hastaya medikal tedavi başlandı. Hastanın ağrılarının lomber bölgeye yayılması nedeniyle diseksiyonun ilerlediği düşünüldü. Hemodinamik olarak stabil hastaya karın ultrasonografisi yapıldı ve diseksiyonun ilerlemediği görüldü. Nörolojik incelemesinde lomber spinoz proçes hassasiyeti, her iki bacak germe testinin 30 derecede pozitif olması üzerine cekilen manyetik rezonans gö-rüntülemede L3-L4'te spondilolistezis ve merkez yerleşimli disk hernisi tespit edildi. Mevcut bulgularla diseksiyon yönünden operasyon endikasyonu olmadığı düşünül-dü. Diskektomi ve füzyon cerrahisi önerildi. Hastanın cerrahi tedaviyi kabul etmemesi üzerine, ilaç tedavisi verilerek taburcu edildi. Bu çalışmada, kronik Tip-B aort diseksiyonlu bir olguda diseksiyonun ilerlemesini taklit eden lomber spondilolistezis'in ayırıcı tanıdaki önemini vurgulamayı amaçladık.Anahtar Sözcükler: Aort diseksiyonu; spondilolistezis.Aortic dissection is an acute lethal cardiovascular condition. A 67-year-old hypertensive woman was admitted to our Emergency Department with an abrupt onset of tearing pain in the interscapular area. A thoracic computed tomography scan with contrast showed chronic type B aortic dissection. The patient was transferred to intensive care and medical therapy was initiated. Upon spread of the pain to the lumbar area, the dissection was thought to have progressed. The patient, being hemodynamically stable, was examined using ultrasonography, and the dissection did not show any progression. In the neurological examination for the lumbar pain, the lumbar processus spinosus was found to be sensitive, and the sciatic nerve stretch test was positive at 30 degrees. Magnetic resonance imaging revealed spondylolisthesis and a centrally located disc herniation at the L3-4 level. No operation for the dissection was planned, but discectomy and fusion surgery was scheduled. Since the patient refused surgery, she was discharged with medical therapy. Our aim in this report was to emphasize the importance of spondylolisthesis mimicking the progression of dissection in the differential diagnosis of a chronic type B aortic dissection case.

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“…Os sintomas da espondilolistese são causados pela instabilidade, provocando estenose estática e dinâmica 6 . O quadro clínico pode variar desde claudicação neurológica, lombalgia e radiculopatia, sendo mais comum a dor lombar intermitente 12,13 .…”

Section: Métodosunclassified

Avaliação dos pacientes submetidos à descompressão e artrodese póstero-lateral devido à espondilolistese degenerativa com dois anos de acompanhamento

Rosa¹,

Foizer²,

Yoshino³

et al. 2012

Coluna/Columna

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OBJETIVO: Avaliar os resultados da descompressão e da artrodese póstero-lateral na espondilolistese degenerativa em pacientes que têm como sintoma principal a claudicação neurogênica. MÉTODO: Foram selecionados 21 pacientes com espondilolistese degenerativa, com indicação de tratamento cirúrgico. Foram avaliados 8 homens e 13 mulheres com idades entre 36 e 77 anos. O procedimento cirúrgico padronizado foi a artrodese póstero-lateral com instrumentação e descompressão associada. Os pacientes foram avaliados por VAS, índice de Oswestry e Roland-Morris no pré-operatório, com um mês, seis meses, um ano e dois anos de seguimento. Os dados foram analisados estatisticamente com nível de significância de 5%. RESULTADOS: O nível mais frequentemente operado foi L4-L5, com 52,38%. A VAS teve melhora significativa de 53,48% nos 6 meses após o procedimento. O Índice de Incapacidade de Oswestry apresentou piora no primeiro mês, evolução para melhora da capacidade até o sexto mês, e permaneceu constante até o fim do acompanhamento. Segundo o questionário de Incapacidade de Roland-Morris, houve melhora progressiva significativa até o sexto mês e, por último, uma leve piora. CONCLUSÃO: Os pacientes com espondilolistese degenerativa submetidos à artrodese póstero-lateral instrumentada e descompressão apresentaram melhora significativa da qualidade de vida e da dor após dois anos de acompanhamento.

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Diagnosis and conservative management of degenerative lumbar spondylolisthesis

Cited by 174 publications

References 54 publications

Prognostic factors in intramedullary astrocytomas: a literature review

Prognostic factors in intramedullary astrocytomas: a literature review

Spondylolisthesis mimicking the progression of dissection in a case of chronic Stanford type B aortic dissection

Avaliação dos pacientes submetidos à descompressão e artrodese póstero-lateral devido à espondilolistese degenerativa com dois anos de acompanhamento

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