• Title, Summary, Keyword: Lumbar Spondylolisthesis

Search Result 77, Processing Time 0.048 seconds

Comparison Study on Lumbar Strength and Lumbar Flexor/Extensor Ratio of Spondylolisthesis Patients and Herniated Disc Patients (척추전방전위증 환자와 추간판탈출증 환자의 요부근 기능과 굴곡/신전근 비율에 관한 비교연구)

  • Jee Yong-Suk;Yu Byong-Kyu;Lee Wan-Hee
    • The Journal of Korean Physical Therapy
    • /
    • v.14 no.3
    • /
    • pp.136-144
    • /
    • 2002
  • The Purpose of this study was to compare the lumbar strength and lumbar flexor/extensor ratio between spondylolisthesis and herniated disc patients. The patients who had a subacute low back pain have been proved to each disease through MRI and we measured the maximal isometric strength of all patients(28) through MedX lumbar extension machine(Ocala, FL). In all patients, males had higher lumbar extensor strength than that of females. Especially, the spondylolisthesis patients had lower lumbar extensor strength than that of herniated disc patients. The statistical significant(p<.05, p<.01) differences were manifested in $48^{\circ},\;60^{\circ}\;and\;72^{\circ}$ between male groups. Also the statistical significant (p<.05) differences were manifested in $60^{\circ}\;and\;72^{\circ}$between female groups. In the lumbar flexor/ extensor ratio, the males of spondylolisthesis groups represented the functional weakness in the flexed portion of the range of motion, and the females of spondylolisthesis and the all patients of herniated disc represented the functional weakness in the extended portion of the range of motion. In conclusion, we may propose the program such that the spondylolisthesis males must increase the ratio of extended portion exercise, and the spondylolisthesis females and herniated disc patients must increase the ratio of flexed portion exercise.

  • PDF

Concurrent Degenerative Cervical and Lumbar Spondylolisthesis (경추 및 요추 퇴행성 척추전위증의 병발성 유병률)

  • Park, Moon Soo;Hwang, Ji-Hyo;Kim, Tae-Hwan;Oh, Jae Keun;Chang, Ho Guen;Kim, Hyung Joon;Park, Kun-Tae;Lim, Jin Kyu;Riew, K. Daniel
    • Journal of Korean Society of Spine Surgery
    • /
    • v.25 no.4
    • /
    • pp.154-159
    • /
    • 2018
  • Study Design: Retrospective radiographic study. Objective: To evaluate the characteristics of concurrent degenerative cervical and lumbar spondylolisthesis. Summary of Literature Review: Concurrent degenerative cervical and lumbar spondylotic diseases have been reported. Given that severe spondylosis can result in spondylolisthesis, one might expect that concurrent spondylolisthesis of the cervical and lumbar spines might also be prevalent. However, the incidence of spondylolistheses in the lumbar and cervical spines might differ due to anatomical differences between the 2 areas. Nonetheless, there is minimal information in the literature concerning the incidence of concurrent cervical and lumbar spondylolisthesis. Material and Methods: We evaluated standing cervical and lumbar lateral radiographs of 2510 patients with spondylosis. Concurrence, age group, gender, and direction of spondylolisthesis were evaluated. Lumbar spondylolisthesis was defined as at least Meyerding grade I and degenerative cervical spondylolisthesis was defined as over 2 mm of displacement on standing lateral radiographs. Results: Lumbar spondylolisthesis was found in 125 patients (5.0%) and cervical spondylolisthesis was found in 193 patients (7.7%). Seventeen patients had both degenerative cervical and lumbar spondylolistheses (0.7%). Lumbar spondylolisthesis is a risk factor for coexisting cervical spondylolisthesis. Lumbar spondylolisthesis was more common in females than males, independent of advancing age. In contrast, degenerative cervical spondylolisthesis was more common in older patients, independent of gender. Anterolisthesis was more common in the lumbar spine. Retrolisthesis was more common in the cervical spine. Conclusions: There was a higher prevalence of degenerative cervical spondylolisthesis in patients with degenerative lumbar spondylolisthesis.

Transforaminal Lumbar Interbody Fusion Using Wedged Cages for Isthmic Spondylolisthesis : A Short-Term Radiological Analysis

  • Lee, Dong-Yeob;Lee, Sang-Ho;Lee, Han-Soon
    • Journal of Korean Neurosurgical Society
    • /
    • v.40 no.5
    • /
    • pp.346-350
    • /
    • 2006
  • Objective : The ability to induce segmental lordosis has been reported to be marginal with transforaminal lumbar interbody fusion[TLIF]. Therefore, we analyzed the short-term radiological outcomes of TLIF using $8^{\circ}$ wedged cages for isthmic spondylolisthesis. Methods : Twenty-seven patients with isthmic spondylolisthesis who underwent single level TLIF with pedicle screw fixation[PSF] using $8^{\circ}$ wedged cages were retrospectively evaluated. Changes in disc height, degree of anterolisthesis, segmental lumbar lordosis, whole lumbar lordosis and L1 axis S1 distance were evaluated using standing lateral radiographs before surgery, at 6 weeks follow-up and at the final follow-up. Results : The mean age of the patients was 49.9 years [range, 38 to 64 years]. The affected levels were L4-5 in 17 cases and L5-S1 in 10. There were 18 cases of Grade I isthmic spondylolisthesis and 9 cases of Grade II. At a mean follow-up duration of 9.9 months [range, 6 to 18 months], the disc height [p< 0.001] was significantly increased, and the degree of anterolisthesis was significantly reduced [p< 0.001]. Regarding the sagittal balance, the segmental lumbar lordosis was significantly increased [p=0.01], but other parameters were not significantly changed after surgery. Conclusion : TLIF with PSF using $8^{\circ}$ wedged cages significantly increased the segmental lumbar lordosis.

A Hybrid Dynamic Stabilization and Fusion System in Multilevel Lumbar Spondylosis

  • Fay, Li-Yu;Chang, Chih-Chang;Chang, Hsuan-Kan;Tu, Tsung-Hsi;Tsai, Tzu-Yun;Wu, Ching-Lan;Huang, Wen-Cheng;Wu, Jau-Ching;Cheng, Henrich
    • Neurospine
    • /
    • v.15 no.3
    • /
    • pp.231-241
    • /
    • 2018
  • Objective: The Dynesys-Transition-Optima (DTO) hybrid system was designed to achieve arthrodesis and stabilization in patients with lumbar degeneration. Satisfactory outcomes were demonstrated previously. However, no study has evaluated the effects of using the DTO system in patients with lumbar spondylolisthesis or stenosis. Methods: This retrospective study included 35 consecutive patients with multilevel lumbar degeneration with or without spondylolisthesis who underwent surgery using the DTO system. Imaging studies included pre- and postoperative radiography, magnetic resonance imaging, and computed tomography. The clinical outcomes were measured by Japanese Orthopedic Association (JOA) scores, Oswestry Disability Index (ODI) scores, and a visual analogue scale (VAS) for back and leg pain. Results: Thirty patients (85.7%) with a mean age of 61.9 years completed the follow-up, with a mean duration of 35.1 months. There were 21 patients in the spondylolisthesis group and 9 in the stenosis group. The spondylolisthesis group had worse functional scores than the stenosis group preoperatively. After DTO surgery, all patients showed significant improvements in clinical outcomes, including VAS for back and leg pain, ODI, and JOA scores (p < 0.05). There were no significant differences in clinical outcomes between the 2 groups. At a 2-year follow-up, lumbar alignment was well maintained in both groups (p = 0.116). There were no significant differences in lumbar alignment between the 2 groups. Conclusion: During a follow-up period of over 2 years, both patients with spondylolisthesis and those with stenosis showed improvements and similar disability and pain scores after surgery using the DTO system. Lumbar alignment was also well maintained.

Effects of Manual Therapy Approach for Lumbar Spondylolisthesis (요추부 전방전위증 환자의 도수치료 효과 연구)

  • Kang, Seok-Yeong;Kim, Myung-Joon;Lee, So-Hee
    • The Journal of Korean of Orthopedic Manual Physical Therapy
    • /
    • v.16 no.2
    • /
    • pp.34-39
    • /
    • 2010
  • Purpose : The purpose of this study is to find out the evidence concerning the effectiveness of manual therapy intervention in the treatment of low back pain related to spondylolisthesis Methods : 12men with lumbar pain from L5~S1 spondylolisthesis of 2 or 3 grade were treated during 12-week period. The manual therapy applied twice per week. The results of back and radiating pain were measured by VAS, and abdominal muscle strength was measured by Power track II. The measurement of degree of slip in spondylolisthesis was confirmed by the lateral view of X-ray and took a measurements of the anterior displacement of a vertebral body in relation to the vertebral below. Results : 1. There was significant decrease in the back and radiating pain.(p<0.05) 2. There was significant increase in the abdominal muscle strength.(p<0.05). 3. There was significant decrease in the degree of the anterior displacement. Conclusion: The intervention of manual therapy for lumbar spondylolisthesis is effective in back pain, radiating pain, abdominal muscle strength and degree of the anterior displacement. So, nonsurgical treatment should be attempted before surgical treatment.

  • PDF

Isthmic Spondylolisthesis Associated with Foraminal Disc Herniation Treated by Anterior Lumbar Interbody Fusion

  • Lee, Dong-Yeob;Lee, Sang-Ho;Maeng, Dae-Hyeon;Jang, Jee-Soo
    • Journal of Korean Neurosurgical Society
    • /
    • v.38 no.4
    • /
    • pp.320-322
    • /
    • 2005
  • A 45-year-old man presented with lower back pain and pain in the right leg of 3years duration. A plain radiographic examination revealed grade I isthmic spondylolisthesis, with instability at L4-5. Computed tomography and magnetic resonance imaging demonstrated bilateral foraminal stenosis, with soft foraminal disc herniation on the right side at the L4-5 level. He underwent anterior lumbar interbody fusion[ALIF] with percutaneous posterior fixation[PF] at the L4-5 level. Without removing the posterior bony structures, removal of foraminal disc herniation and reduction of spondylolisthesis were successfully performed using ALIF with percutaneous PF. When there is no hard disc herniation or lateral recess stenosis, ALIF with percutaneous PF can be one of the treatment options for isthmic spondylolisthesis, even in the presence of foraminal disc herniation, as in our case.

Clinical Study of the Treatment of Spondylolisthesis with Lumbar Herniated Intervertebral Disc (요추 추간판 탈출증을 동반한 척추전방전위증의 한방치료에 관한 임상적 고찰)

  • Kim, Tae-Ho;Yoon, Tae-Kyung;Yun, Young-Ung;Jeong, Seon-Yeong;Lee, Cha-Ro
    • The Journal of Korea CHUNA Manual Medicine for Spine and Nerves
    • /
    • v.9 no.1
    • /
    • pp.15-26
    • /
    • 2014
  • Objectives : The purpose of this study was to evaluate the effect of Korean medicicine treatment in patients with Spondylolisthesis and Lumbar Herniated Intervertebral Disc(HIVD). Methods : This clinical study was carried out on 62 patients who were diagnosed as spondylolisthesis and lumbar herniated intervertebral disc(HIVD) on L-spine X-ray and L-spine magnetic resonance imaging(MRI), who had been admitted from Feb. 2013 to Apr. 2014. All of 62 patients were treated with acupuncture, chuna treatment and herbal medicine during the whole admission period. Numerical rating scale(NRS) was used to evaluated the effectiveness of the oriental medical treatment. Results : 1. Distribution showed female predominance in general. 2. Degenerative type is the most common in this study. 3. In the duration of symptoms, the largest group was" Subacute"(32.26%). 4. Almost of patients had radiation pain, but in SLR test and valsalva test, more patients had no significant sign. 5. Spondylolytic type involved the 5th lumbar vertebra in 80% and degenerative type involved the 4th lumbar vertebra in 53.84%. 6. Most of case were grade 1(93.54%) in degree of slipping. 7. By the oriental medical treatment, NRS reduction in spondylolytic spondylolisthesis, was better than degenerative spondylolisthesis. Conclusions : The result of treatment by Korean medical is satisfactory for the tretment of spondylolisthesis.

  • PDF

Sagittal Pelvic Radius in Low-Grade Isthmic Lumbar Spondylolisthesis of Chinese Population

  • Zhao, Yang;Shen, Cai-Liang;Zhang, Ren-Jie;Cheng, Da-Wei;Dong, Fu-Long;Wang, Jun
    • Journal of Korean Neurosurgical Society
    • /
    • v.59 no.3
    • /
    • pp.292-295
    • /
    • 2016
  • Objective : To investigate the variation of pelvic radius and related parameters in low-grade isthmic lumbar spondylolisthesis. Methods : Seventy-four patients with isthmic lumbar spondylolisthesis and 47 controls were included in this study. There were 17 males and 57 females between 30 and 66 years of age, including 30 with grade I slippages and 44 grade II slippages; diseased levels included 34 cases on L4 and 40 cases on L5. Thoracic kyphosis (TK), the pelvic radius (PR), the pelvic angle (PA), pelvic morphology (PR-S1), and total lumbopelvic lordosis (PR-T12) were assessed from radiographs. Results : Statistically significant differences were found for the PA, PR-T12, and PR-S1 ($24.5{\pm}6.6^{\circ}$, $83.7{\pm}9.8^{\circ}$, and $25.4{\pm}11.2^{\circ}$, respectively) of the patients with spondylolisthesis and the healthy volunteers ($13.7{\pm}7.8^{\circ}$, $92.9{\pm}9.2^{\circ}$, and $40.7{\pm}8.9^{\circ}$, respectively). The TK/PR-T12 ratios were between 0.15 and 0.75. However, there were no differences in all the parameters between the L4 and L5 spondylolysis subgroups (p>0.05). The TK and PR-S1 of grade II were less than grade I, but the PA was greater. The PR-T12 of female patients were less than male patients, but the PA was greater (p<0.05). Conclusion : Pelvic morphology differed in patients with low-grade isthmic lumbar spondylolisthesis compared to controls. Gender and the grade of slippage impacted the sagittal configuration of the pelvis, but the segment of the vertebral slip did not. Overall, the spine of those with spondylolisthesis remains able to maintain sagittal balance despite abnormal pelvic morphology.

Surgical Results of Patients with Isthmic Spondylolisthesis with Transpedicular Screw Fixation and Posterior Lumbar Interbody Fusion Using Posterior Movable Segment (협부형 척추전방전위증에 대한 후방가동관절 이용한 골유합술 및 척추경나사못 고정술의 수술적 결과)

  • Kim, Chan;Lee, Seung Myung;Shin, Ho
    • Journal of Korean Neurosurgical Society
    • /
    • v.30 no.sup1
    • /
    • pp.108-114
    • /
    • 2001
  • Objective : Posterior lumbar interbody fusion(PLIF) provides the favorable outcome to degenerative lumbar disease, especially isthmic spondylolisthesis. To determine the long-term effect of PLIF using psterior movable segment, we analysed the results of follow-up radiologic changes and surgical outcome retrospectively Patients and Method : During the past 11 years(1989. 1.-1999. 9.), 148 patients with symptomatic lumbar spondylolisthesis were managed at our department and the clinical wants were throughly recieved and final outcome is determined at last follow up. PLIF using antogenous bone(posterior movable segment, iliac bone and rib) were performed in 106 case. Results : After an average follow-up period of 33 months(range ; 15-58 months), the results were excellent in 66 cases, good in 37 cases, fair in 2 cases and poor in 1 cases. And the satisfactory results were 103 cases(98.2%) in PLIF,. Conclusion : In conclusion, patients who underwent PLIF with autologous bone graft had good clinical and radiological outcomes without significant neurological complications.

  • PDF

Comparison of Clinical and Radiological Outcomes of Lumbar Interbody Fusion Using a Combination of Hydroxyapatite and Demineralized Bone Matrix and Autografts for Lumbar Degenerative Spondylolisthesis

  • Gatam, Asrafi Rizki;Gatam, Luthfi;Tobing, Singkat Dohar Lumban
    • Asian Spine Journal
    • /
    • v.11 no.5
    • /
    • pp.706-714
    • /
    • 2017
  • Study Design: Prospective, cohort, non-inferiority study. Purpose: This study evaluated the clinical and radiological outcomes of interbody fusion using a combination of demineralized bone matrix (DBM) and hydroxyapatite (HA). Overview of Literature: The use of autografts remains a gold standard in lumbar interbody fusion, but the limited availability and donor site morbidity encourages the use of bone substitutes. In addition to autografts, a combination of HA and DBM is being increasingly use for lumbar interbody fusion. However, there are no data on the clinical and radiological outcomes of this procedure. Methods: We examined 35 patients with lumbar degenerative spondylolisthesis who underwent transforaminal interbody fusion. Autografts were used in 18 patients, and 17 patients received a combination of HA and DBM. Clinical outcomes were evaluated using the visual analog scale (VAS) for back and leg pain, Oswestry disability index (ODI), and Japanese Orthopaedic Association (JOA) scores at 3, 6, and 12 months postoperatively. Fusion was evaluated using computed tomography images obtained at 12 months postoperatively. Results: The mean ODI, JOA, and back and leg pain VAS scores increased significantly in both groups. However, the VAS, JOA, and ODI scores did not differ significantly between the two groups (p=0.599, p=0.543, and p=0.780, respectively). The fusion rates at 1 year postoperatively were 77.8% and 76.5% in the autograft and HA+DBM groups, respectively (p=0.99). Conclusions: The clinical and radiological outcomes of using a combination of HA and DBM in lumbar interbody fusion were not inferior to those of using autografts. A combination of HA and DBM can be considered as an alternative in patients with lumbar degenerative spondylolisthesis requiring surgery.