Multilevel Thoracolumbar Spondylolysis with Spondylolisthesis at L4 on L5

Kim, Whoan Jeang; Song, Young Dong; Choy, Won Sik

doi:10.4055/cios.2015.7.3.410

Cited by 3 publications

(4 citation statements)

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“…научных публикаций, посвященных изолированному спондилолизу грудной локализации обнаружить не удалось, за исключением описания случая диагностики многоуровневого дефекта дуг с одновременным вовлечением в процесс всех пяти поясничных позвонков и двенадцатого грудного [45].…”

Section: материал и методыunclassified

“…учитывая тот факт, что основным клиническим симптомом спондилолиза являются боли, в литературе активно обсуждается лечебная тактика в отношении пациентов, страдающих этой патологией [21,55,70,71]. Значительная часть исследователей придерживается консервативного метода в купировании болевого синдрома, используя в качестве лечебных средств исключение нагрузок на поясничный отдел позвоночника, физиотерапию, корсетирование, массаж, лекарственные средства и мануальную терапию [45,46,52,65,72,73]. Оперативное лечение спондилолиза также нашло широкое применение в тактике лечения этой категории больных [2,5,64,70,[74][75][76].…”

Section: материал и методыunclassified

“…Мы обнаружили 14 публикаций зарубежных авторов, описывающих клинические случаи многоуровневого спондилолиза в общей сложности у 21 пациента различного возраста. При этом публикации 12 исследователей посвящены описанию всего лишь одного клинического случая патологии [2,16,23,28,39,45,65,73,74,[78][79][80]. Еще по одному автору описывают течение изучаемой патологии у пяти [70] и трех [18] Отдельно следует выделить клинические наблюдения c. Zhang с соавторами за 9 пациентами, у каждого из которых был диагностирован спондилолиз поясничных позвонков на двух уровнях и, как следствие, сформировавшийся на этих же уровнях спондилолистез.…”

Section: материал и методыunclassified

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Isolated and Multilevel Spondylolysis (Literature Review)

Скрябин¹

2019

Traumatology and Orthopedics of Russia

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One of the main causes of lumbar spine pain is spondylolysis. The purpose of this review is to present the current state of the problem of diagnosis and treatment isolated and multilevel spondylolysis.Materials and Methods. The review includes 86 publications on the problem of spondylolysis for 2005–2019, obtained from electronic databases: PubMed, Cochrane Library, eLIBRARY, CYBERLENINKA.Results. There is still the only known classification of spondylolysis by P. Niggemann et al, which includes four severity of this pathology — from mild to very severe: A, BI, BII, BIII. The classification is based on the nature of changes in the area of bone defect of the vertebral arch when the patient performs functional tests. In some cases, the pathology can be regarded as a transition between different degrees of severity of type B. The treatment of spondylolysis can be both conservative and operational. The conservative therapy consists of physical activity restriction, physiotherapy, wearing a corset, massage, and pharmacotherapy. The purpose of surgical treatment is the removal of fibrous tissue from the zone of spondylolysis and the achievement in this area the bone fusion via a bone autoplasty and(or) osteosynthesis with different metal frameworks. Reasoned arguments about the need for a combination of conservative and surgical treatment of patients with spondylolysis are also reflected in the publications. Information on multilevel spondylolysis is represented by a small number of articles. only 15 authors described clinical cases of multilevel spondylolysis in a total of 21 patients. Spondylolysis is a high risk factor for the spondylolisthesis formation. Among the various categories of patients suffering from spondylolysis and lumbar spondylolysis spondylolisthesis, pregnant women are of particular interest. Hormonal restructuring and changes in the biomechanics of the spine in women during the gestational period often leads to the appearance or intensification pain syndrome in lumbar spine complicating the pregnancy, and hence a fetus development.Conclusion. Timely diagnosis of spondylolysis and the subsequent development of individual rehabilitation not only improves the quality of life of patients, but in some cases can prevent such a serious pathology as spondylolisthesis.

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Section: материал и методыunclassified

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Isolated and Multilevel Spondylolysis (Literature Review)

Скрябин¹

2019

Traumatology and Orthopedics of Russia

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“…39 Multiple-level lumbar spondylolysis and spondylolisthesis are not common, with few studies reported on them. 10,12,19,20,25,26,[37][38][39] The reported incidence is only 1.48% of patients with back pain and 0.3% of 2000 persons examined by computed tomography . 11,38,39 While instrumented posterolateral fusion (PLF) is a rapid traditional effective fusion technique for the treatment of spinal instability, 1 posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) are more commonly used nowadays to treat spondylolisthesis owing to their theoretical advantages.…”

Section: Introductionmentioning

confidence: 99%

Multiple-Level Low-Grade Lumbar Spondylolisthesis: Instrumented Posterolateral Fusion Using a Local Bone Graft

Said

Abdel-Wanis

Ameen

et al. 2020

Egyptian Spine Journal

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Background Data: Lumbar spondylolisthesis is a major cause of back pain. It occurs most commonly at only one spinal level. Multiple-level lumbar spondylolisthesis is uncommon, with few reports available in the literature. It can be treated by instrumented posterolateral fusion (PLF) using iliac crest bone graft (ICBG) with possible reported donor site complications. A reasonable alternative is local bone graft obtained from the laminae and spinous processes harvested during neural decompression. Purpose: To evaluate the outcome of multiple-level spondylolisthesis treated by PLF using a local bone graft. Study Design: Prospective clinical case series. Patients and Methods: Eleven patients (6 males and 5 females) with mean age 48.18 ± 9.7 years with multiple-level lumbar spondylolisthesis who underwent PLF using local bone graft in our University Hospital between 2015 and 2017 were evaluated. The mean duration of low back pain (LBP) was 11.36 ± 1.8 (range, 9-14) months. Operation time and blood loss were recorded. Clinical outcomes were evaluated using the Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI), while fusion was evaluated using the Lenke classification for posterolateral fusion. Results: The mean operative time was 87.7 ± 19.1 minutes, while blood loss was 541.8 ± 135.5 ml, and the mean follow-up period was 34.55 ± 3.2 months. VAS and ODI improved significantly from preoperatively to postoperatively and at last follow-up (p < 0.05) with no significant difference in terms of gender or age. Radiologically, solid bone fusion was achieved in 23 out of 27 operated levels (85%). One screw was broken, and two patients had superficial wound infections. Conclusion: Our data suggest that instrumented PLF using local bone graft can effectively be used to manage multiple-level lumbar spondylolisthesis with satisfactory outcome and avoid ICBG donor site morbidity. (2020ESJ222)

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Multilevel lumbar spondylolysis: case report and literature review

Скрябин¹,

Akselrov²,

Lebedev³

2020

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Introduction Diagnosis and treatment of vertebrogenic pain syndrome caused by multilevel lumbar spondylolysis is crucial for patients of different age groups. Objective To report a clinical case of diagnosis and treatment of a two-level lumbar spondylolysis in a 16-year-old male patient, and review the relevant literature. Material and methods We had an experience of treatment and follow-up of a 16-year-old athlete who presented with low back pain and was diagnosed with spondylolysis of the pars interarticularis at the L3 and L5 levels. Diagnostic workup included patient history, physical examination, diagnostic imaging (plain radiograph, computed tomography). Scientific publications from modern medical databases were used for literature review. A total of 32 relevant articles brought out between 1975 and 2019 were reviewed. Results The 16-year-old athlete was diagnosed with multilevel spondylolysis of lumbar spine based on patient history, physical examination data and diagnostic imaging of lumbar spine. No pathognomonic clinical findings were revealed. The diagnosis was confirmed with computed tomography. Conservative treatment was initiated for the patient and a long-termfollow- up was available. Literature review included epidemiologic data characterizing multilevel lumbar spondylolysis: the indicence, patients' gender and age. Major etiological factors, common localization of the pathology, the incidence of spondylolysis and spondylolisthesis, treatment strategy including surgical procedures are described. Discussion There is a small number of scientific publications describing different aspects of multilevel spondylolysis of the lumbar spine in the current medical literature. The diagnosis is often delayed for the reason. The natural history of pain in adolescent athletes sustaining the load placed on them in both training and competition can be helpful for timely diagnosis. Conclusion The implications of this clinical case report can be practical for accentuation of multilevel spondylolysis of the lumbar spine among Russian specialists, contribute to medical knowledge and extend to both early diagnosis and efficient management.

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Multilevel Thoracolumbar Spondylolysis with Spondylolisthesis at L4 on L5

Cited by 3 publications

References 11 publications

Isolated and Multilevel Spondylolysis (Literature Review)

Isolated and Multilevel Spondylolysis (Literature Review)

Multiple-Level Low-Grade Lumbar Spondylolisthesis: Instrumented Posterolateral Fusion Using a Local Bone Graft

Multilevel lumbar spondylolysis: case report and literature review

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