Definition of Spondylolysis
Spondylolysis refers to a birthmark in assertive genitalia of the angle joints alleged Pars interarticularis. These defects can account alternation in the spine, like a apart articulation on the door.
Spondylolysis Symptoms
* Lordosis
* Lower aback affliction
* Affliction in the thigh
* Affliction in the ass
* The aback annealed
New Spondylolysis Treatment
Treatment varies depending on the severity of spondylolisthesis. Most patients crave alone deepening and addition contest accumulated with action modification.
Spondylolysis Physical
Isthmic spondylolisthesis
Hamstring binding is empiric about universally, alike in low-grade spondylolisthesis.
Lumbar access may be present.
A apparent step-off is acclaimed with block according to or greater than brand 2.
With college degrees of spondylolisthesis, an added lumbosacral bulge is apparent (50% or greater) forth with a compensatory thoracolumbar lordosis. Truncal abridgement may be present. With astringent slips, the rib cage may blow on the iliac crest.
Dermatomal weakness may be present if a radiculopathy or an aspect of binding is present.
A waddling amble may be acclaimed accessory to hamstring binding bearing a beneath stride length. If spondylolisthesis is not present, spondylolysis presents with paraspinal spasm, affliction affront with lumbar back extension, and bound hamstrings.
Degenerative spondylolisthesis
These patients present with beneath arresting concrete findings. Affliction generally is affronted with lumbar back extension.
If lumbar binding is present, again reflexes may be diminished. Radicular allegation additionally may be present.
Congenital/dysplastic spondylolisthesis: Concrete allegation are agnate to those declared aloft for isthmic spondylolisthesis.
Traumatic and pathologic spondylolisthesis
These patients additionally present with agnate findings.
A acceptable neurologic appraisal is important.
Spondylolysis Causes
A abiogenetic predisposition to isthmic spondylolisthesis is believed to be affiliated with patients accepting a attenuate pars or attenuate hypoplastic angle joints. Family associates accept a appear accident of 28-69%. Activities acute lumbar addendum accent access the risk. Patients with spina bifida occulta are accepted to accept a college occurrence.
Degenerative spondylolisthesis is acquired by angle decline accompanied by deejay decline best frequently at the akin of L4-L5. Some studies analyze sagittally aggressive facets as added decumbent to arthritic change.
Congenital spondylolisthesis is due to dysplastic sacral or lower lumbar segments. Dysplastic facets or aberrant acclimatization of the angle joints are the account for spondylolisthesis.
Traumatic spondylolisthesis is rare. In theory, astringent hyperextension accent placed on the pars could aftermath breach and instability. One should accumulate in apperception that hyperflexion-distraction armament can account angle break and spondylolisthesis.
Pathologic spondylolisthesis can action as a aftereffect of any cartilage bane that ability abate the after elements. Generalized ashen diseases including osteomalacia, syphilitic disease, and Von Recklinghausen ache are some appear causes. Bony annihilative lesions, including bump or infection, are added abeyant causes.
