The direct fusion methods for repair of spondylolytic defects of the lumbar spine have recently been replaced by transpedicular screw fixation of the affected segment, in combination with PLIF, TLIF or ALIF procedures. However, in clearly indicated cases, such as a younger patient with no intervertebral disc degeneration and only minimal or no displacement of the vertebra, the direct repair techniques have a great advantage over transpedicular fixation because they preserve segmental motion The paper reports on a patient with spondylolysis at L3 who underwent surgery combining the Tokuhashi and Matsuzaki and the Gillet and Petit techniques, which involved a system of transpedicular screws, rods and sublaminar hooks supplemented with a cross-connector to support the base of the spinous process. After surgery, the patient reported pain relief and return to normal activities and CT examination showed bony union of both spondylolytic defects.
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Article Synopsis
- This study aimed to describe and verify a technique for visualizing the L5 pars interarticularis (L5PI) using diagnostic ultrasound (DUS) on a healthy 10-year-old boy.
- The methodology involved scanning the L5/S1 region with a linear array transducer and confirming the L5PI's identification through comparisons with spine models and imaging a subject known to have spondylolysis.
- Results indicated that the ultrasound images matched the models with a metal paperclip placed over L5PI, and spondylolysis showed a distinct defect at this site, establishing the DUS technique as effective for diagnosing L5PI.
Surgical management of congenital cervical spondylolytic spondylolisthesis: illustrative case.
J Neurosurg Case Lessons
August 2024
Department of Neurosurgery, IRCCS Humanitas Research Hospital, Milan, Italy.
Article Synopsis
- Congenital cervical spondylolytic spondylolisthesis is a rare disorder affecting the cervical spine, typically requiring surgery only for symptomatic patients who don’t respond to conservative treatments.
- A 34-year-old man with symptoms of bilateral C7 radiculopathy was diagnosed with grade II spondylolisthesis and underwent C6-7 anterior fusion surgery, leading to symptom improvement and initial evidence of bony bridging.
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Imaging predictors of progression of lumbar spondylolysis to spondylolisthesis: a systematic review.
Spine J
August 2024
Spine Labs, St George and Sutherland Clinical School, University of New South Wales, 10 South Street, Kogarah, New South Wales, Australia; Spine Service, Department of Orthopaedic Surgery, St George and Sutherland Clinical School, University of New South Wales, Suite 16 Level 5, 1 South Street, Kogarah, New South Wales, Australia.
Background Context: Isthmic spondylolisthesis (IS) is defined as the anterior translation of one lumbar vertebra relative to the next caudal segment as a result of a unilateral or bilateral fracture of the pars interarticularis. These fractures are interchangeably known as "pars defects" or "spondylolysis." Many risk factors have been proposed to explain the progression of a spondylolytic defect to IS, however, none are validated.
View Article and Find Full Text PDFL4/5 Disc Herniation: Not Unusually Accompanied with L5/S1 Low-Grade Spondylolytic Spondylolisthesis.
Orthop Surg
February 2024
Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
Objective: Isthmic spondylolisthesis (IS) is distinguished by a congenital defect or acquired fracture of the pars interarticularis. Numerous studies on L5 low-grade IS have been carried out; however, there is a paucity of data regarding the condition of L5 IS concomitant with L4/5 disc herniation. This study aimed to identify the incidence rate and to illustrate the possible risk factors for L4/5 disc herniation in L5 low-grade IS patients.
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