Spondylolysis /waist slip
What is spondylolisthesis?
Spondylolisthesis is the forward shift of a vertebra over another vertebra below a. The bone bridge that normally connects the anterior and posterior parts of the vertebrae and called the pars articularis is broken on both sides, which makes this slippage possible. This condition is called spondylolysis.
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Spondylolisthesis
Who gets spondylolisthesis and why?
The deterioration of the integrity of the bone bridges, which we define as spondylolysis, which will lead to spondylolisthesis in the future, can develop as a result of many different reasons. This bone bridge integrity may not be congenital (congenital spondylolisthesis); or as a result of subsequent repetitive traumas (isthmic spondylolisthesis) may develop. The most important cause of isthmic spondylolisthesis, which is seen mostly at young ages, is sports that force the spine to move beyond normal limits. Examples of these sports are contact sports such as gymnastics, ballet, football, and weight training. Another important developmental path that we can say is the loss of support and resistance , which we see mostly in advanced age groups, and the time-related degenerations in the intervertebral joints and fluid cushions, and the loss of support they should provide against spinal movements, As a result, they cannot prevent the vertebrae from sliding forward (degenerative spondylolisthesis).
How is spondylolisthesis classified?
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Grade 1
< 25% Slip
Grade 2
25 - 50% Offset
Normal
Grade 3
50 - 75% Slip
Grade 4
> 75% Slip
What are the symptoms of spondylolisthesis?
The most common clinical complaint is low back pain. This pain often radiates to the legs. Spasm and pain in the muscles at the back of the thigh are important symptoms, and the occurrence of these symptoms, especially in young people and children who play sports, should suggest spondylolisthesis. In advanced cases, pain and numbness spreading to the feet and loss of reflex and movement can be seen due to nerve compression.
How is spondylolisthesis diagnosed?
Diagnosis can be made easily with direct x-rays and computed tomography (CT / CT).
What is the treatment for spondylolisthesis?
Medical treatment and physical therapy are sufficient for the improvement of the complaints in patients who are classified as Grade 1 and 2 and have no progression in the amount of slippage.
Rest, painkillers, hot application, use of corsets in the painful period reduce the complaints. Exercises that strengthen the waist and abdominal muscles after the acute period prevent the progression of slippage and are useful in reducing the frequency of complaints.
Surgical treatment should be preferred in Grade 1 and 2 shifts observed to progress and grade 3 and 4 shifts. In surgical treatment, the pressure on the pinched nerves is removed, and stabilization is provided by placing screws. By adding bone tissue to this area, the fusion of the vertebrae is ensured and the possibility of slippage is eliminated.