Sacrospinous ligaments Interosseous ligaments These three coronal MR images show a portion of the extensive network of ligaments and muscles that stabilize the bony pelvis. They also can cause the pelvis to shift due to unopposed pull when high impact forces separate bone or joints causing pelvic opening.
Home Spondylolisthesis — Isthmic Spondylolisthesis is a condition of spinal instability, in which one vertebra slips forward over the vertebra below. Isthmic spondylolisthesis, the most common form of this condition, is caused by a bony defect or fracture in an area of the pars interarticularis, an area located in the roof laminae of the vertebral structure.
The condition most commonly affects the fourth and fifth lumbar vertebrae L4 and L5 and the first sacral vertebra S1. It is interesting to note that the condition is not always painful. Symptoms Symptoms of isthmic spondylolisthesis may include the following: In severe cases, the condition may cause swayback and a protruding abdomen, a shortened torso, and a waddling gait.
What Causes Isthmic Spondylolisthesis? Isthmic spondylolisthesis can be the result of a genetic failure of bone formation in the spinal vertebrae. Usually physical stresses to the spine then break down the weak or insufficiently formed vertebral components.
Repeated heavy lifting, stooping, or twisting can cause small fractures to occur in the vertebral structure and lead to the slippage of one vertebra over another.
Weightlifters, football players, and gymnasts often suffer from this disorder due to the considerable stress placed on their spines. Diagnosis To make an accurate diagnosis, the physician will conduct a careful and rigorous diagnostic process, including: The physician will talk to you about your symptoms, how severe they are, and what treatments you have already tried.
You will be carefully examined for limitations of movement, problems with balance, and pain.
During this exam, the doctor will also look for loss of reflexes in the extremities, muscle weakness, loss of sensation or other signs of neurological damage.
Generally, doctors start with plain x-rays, which allow us to rule out other problems such as tumors and infections. In some patients we may need a myelogram.
This is a test that involves the use of a liquid dye that is injected into the spinal column to show the degree of nerve compression and slippage between involved vertebrae.
Your surgeon will discuss with you the extent of your spondylolisthesis and how the severity indicates the type of treatment that is needed. In general, most physicians use the Meyerding Grading System for classifying slips.
This is a relatively easy to understand system. Slips are graded on the basis of the percentage that one vertebral body has slipped forward over the vertebral body below. If the body completely slips off the body below it is classified as a Grade V slip, known as spondyloptosis.
Your physician will consider the degree of slip, and such factors as intractable pain and neurological symptoms, when deciding on the most suitable treatment. As a general guideline, the more severe slips especially Grades III and above are most likely to require surgical intervention.
Surgical Treatment Surgery is rarely needed unless the case is severe usually Grade III or aboveneurological damage has occurred, the pain is disabling, or all non-operative treatment options have failed.
The most common surgical procedure used to treat spondylolisthesis is called a laminectomy and fusion. In this procedure, the spinal canal is widened by removing or trimming the laminae roof of the vertebrae. This is done to create more space for the nerves and relieve pressure on the spinal cord.
The surgeon may also need to remove all or part of the vertebral disc discectomy and then also fuse vertebrae together. If fusion is done, various devices like screws or interbody cages may be implanted to enhance fusion and to support the unstable spine.
Prevention is Key While it may not be possible to prevent all spine problems, there are things you can do to help keep your spine healthy.
The most important prevention method is to avoid or limit those work or recreational activities that cause considerable stress to your spine. Losing weight, starting a regular exercise regimen, not smoking, and learning proper body mechanics can all help reduce the risk of further back problems.Surgical treatment of isthmic spondylolisthesis is reserved to the symptomatic case who failed conservative treatment or developed neurological deficits.
The gold standard treatment is surgical fixation of the slipped segments with neural decompression. Imaging The Sacrum and Coccyx Imaging of the sacrum and coccyx is a common procedure in radiology. This article discusses various protocols for plain-film and CT imaging. We have compiled the definitions of over different terms used in brain and spinal cord injury treatment and timberdesignmag.comtanding the terms used in the first step in becoming an effective part of the treatment team.
In Press. Chu MP, Lieffers J, Ghosh S, Belch A, Chua NS, Fontaine A, Sangha R, Turner RA, Baracos VE, Sawyer MB. Skeletal muscle density is an independent predictor of diffuse large B-cell lymphoma outcomes treated with rituximab-based chemoimmunotherapy, J Cachexia Sarcopenia Muscle, (In Press).
(Epub Nov 21, ahead of print. Swan J, Hurwitz E, Malek F, van den Haak E, Cheng I, Alamin T, et al. Surgical treatment for unstable low-grade isthmic spondylolisthesis in adults: a prospective controlled study of posterior instrumented fusion .
Fusion for Treatment of Isthmic Spondylolisthesis Gazi Shahinur Akter, Md Zakirul Hasan, Dur-E-Shehvar Sana, Saiful Islam Nayem, Md Shoriful Islam and Mohammad Abdul Mazid* fusion and circumferential fusion are a relatively common surgical method for the treatment of spondylolisthesis, we Nayem SI, Islam MS, et al.