Spondylolisthesis: Etiology, Diagnosis, Clinical Features and Treatment

Year 2018, Volume: 71 Issue: 3, 118 - 126, 25.12.2018

Esra Moustafa

https://doi.org/10.4274/atfm.36844

Abstract

Spondylolisthesis is anterior or posterior shift according to the vertebrae to which a vertebrate is associated. It is confronted as a broad clinical spectrum ranging from simple mechanical back pain to progressive neurological deficits and radiological findings. Prevalence is 3-6% and male/ female ratio is 2. The diagnosis of spondylolisthesis is almost always made with direct radiographs. Computed tomography (CT), magnetic resonance imaging (MRI), other radiological diagnostic methods such as bone scintigraphy are also used in diagnosis or follow-up. Conservative treatment includes activity restriction, rehabilitation of abdominal and paraspinal muscles and hyperlordotic rigid bracing. The main goal is to reduce pain, strengthen the core of the muscles and to provide complete lumber motion. Surgical treatment is usually performed in patients who do not respond to conservative treatment. We aimed to review current literature regarding the etiology, diagnosis, clinical features and treatment of spondylolisthesis.

Keywords

Spondylolisthesis , Anterolisthesis , Classification , Treatment , Exercise

Ethical Statement

-

Supporting Institution

-

Project Number

-

Thanks

-

Spondilolistezis: Etiyoloji, Tanı, Klinik Özellikler ve Tedavi

Abstract

Spondilolistezis, bir vertebranın ilişkili olduğu vertebraya göre öne veya arkaya kaymasıdır. Basit mekanik bel ağrısından, ilerleyici nörolojik defisit ve radyolojik bulgulara kadar değişen geniş bir klinik spektrum olarak karşımıza çıkmaktadır. Prevalansı %3-6 arasında ve erkek/kadın oranı: 2’dir. Spondilolistezisin tanısı hemen her zaman direkt grafiler ile konulur. Bilgisayarlı tomografi (BT), manyetik rezonans görüntüleme (MRG) ve ayrıca kemik sintigrafi gibi diğer radyolojik tanısal yöntemler tanı veya izlemde kullanılmaktadır. Konservatif tedavi aktivite kısıtlaması, abdominal ve paraspinal kaslarının rehabilitasyonu ve hiperlordotik rijid korselemeyi içerir. Tedavide ana hedef; ağrıyı azaltmak, lomber eklem hareket açıklığını tamamlamasının sağlamak ve kor kaslarını güçlendirmektir. Cerrahi tedavi genelllikle konservatif tedaviye cevap vermeyen hastalara uygulanır. Bu derlemede; spondilolistezis etiyolojisi, tanısı, klinik özellikleri ve tedavisine ilişkin güncel literatürün gözden geçirilmesi amaçlanmıştır.

Keywords

Spondilolistezis , Anterolistezis , Sınıflandırma , Tedavi , Egzersiz

Ethical Statement

Editörler kurulu tarafından değerlendirilmiştir.

Supporting Institution

-

Project Number

-

Thanks

-

References

• 1. Metkar U, Shepard N.Conservative management of spondylolysis and spondylolisthesis. Semin Spine Surg. 2014;26:225-229.
• 2. Haun DW, Kettner NW. Spondylolysis and spondylolisthesis: a narrative review of etiology, diagnosis,and conservative management. J Chiropr Med. 2005;4:206-217.
• 3. Lonstein JE. Spondylolisthesis in Children Cause, Natural History and Management. Spine. 1999;24:2640-2648.
• 4. Panjabi MM. The stabilizing system of the spine, Part I Function, dysfunction, adaptation and enhancement. J Spinal Disord. 1992;5:383-389; discussion 397.
• 5. Özer AF. Lomber Dejeneratif Disk Hastalığı ve Dinamik Stabilizasyon.1.bs. Pelikan Kitapevi. 2011.
• 6. Suzer T. Lumbar Segmental Instability and Deformity. Turk Neurosurg. 2014;24(Supplement:1):20-2820.
• 7. Duvorak J, Panjabi MM, Novotny JE, et al. Clinical validation of functionalflexion-extension roentgenograms of the lumbar spine. Spine. 1991;16:943- 950.
• 8. Wollowick AL, Sarwahi V. Spondylolisthesis Diagnosis, Non-Surgical Management and Surgical Techniques.1th Ed. Springer. 2015.
• 9. Herkowitz HN, Garfin SR, Eismont FJ, et al. Rothman-Simeone:The Spine. Elsevier.6th Ed.2011.
• 10. Kalichman L, Kim DH, Li L, et al. Spondylolysis and spondylolisthesis: prevalence and association with low back pain in the adult communitybased population. Spine (Phila Pa 1976). 2009;34:199-205.
• 11. Standaert CJ, HerringSA. Spondylolysis: a critical review. Br J Sports Med. 2000;34:415-422.
• 12. Garet M, Reiman MP, Mathers J, et al. Nonoperative Treatment in Lumbar Spondylolysis and Spondylolisthesis: A Systematic Review. Sports Health. 2013;5:225-232.
• 13. Wynne-Davies R, Scott JH. İnheritance and spondylolisthesis:a radiographic family survey. J Bone Joint Surg Br. 1979;61-B:301-305.
• 14. McNeely ML, Torrance G, Magee DJ. A systematic review of physiotherapy for spondylolysis and spondylolisthesis. Man Ther. 2003;8:80-91.
• 15. Bridwell KH. The Textbook of Spinal Surgery. 3th Ed.Lippincott Williams& Wilkins.2011.
• 16. Kalichman L, Hunter DJ. Diagnosis and conservative management of Degenerative spondylolisthesis. Eur Spine J. 2008;17:327–335.
• 17. Schuller S, Charles YP, Steib JP. Sagittal spinopelvic alignment and body mass index in patients with degenerative spondylolisthesis. Eur Spine J. 2011;20:713–719.
• 18. Grannum S, Torrie PAG, Miller A, et al. Risk Factors For the Development of a Mobile Degenerative Spondylolisthesis at L4-L5. Spine Deform. 2015;3:98-104.
• 19. Koreckij TD, Fischgrund JS. Degenerative Spondylolisthesis. J Spinal Disord Tech. 2015;28:236–241.
• 20. Cavalier R, HermanMJ. Spondylolysis and Spondylolisthesis in Children and Adolescents: I.Diagnosis, Natural History, and Nonsurgical Management. J Am Acad Orthop Surg. 2006;14:417-424.
• 21. Tebet MA. Current concepts on the sagittal balance and classification of spondylolysis and spondylolisthesis. Rev Bras Ortop. 2014;49:3-12.
• 22. Labelle H, Mac-Thiong JM, Roussoul P. Spino-pelvic sagittal balance of spondylolisthesis:a review and classification. Eur Spine J. 2011;20 Suppl 5:641-646.
• 23. Omidi-Kashani F, Ebrahimzadeh MH. Lumbar Spondylolysis and Spondylolytic Spondylolisthesis: Who Should Be Have Surgery? An Algorithmic Approach. Asian Spine J. 2014;8:856-863.
• 24. Standaert CJ, Herring SA. Expert opinion and controversies in sports and musculoskeletal medicine: the diagnosis and treatment of spondylolysis in adolescent athletes. Arch Phys Med Rehabil. 2007;88:537-40.
• 25. Miller SF, Congeni J, Swanson K. Long-term functional and anatomical follow-up of early detected spondylolysis in young athletes. Am J Sports Med. 2004;32:928-933.
• 26. Frontera WF. Delisa Fiziksel Tıp ve Rehabilitasyon.5. Bs.Güneş Tıp Kitapevleri. 2014.
• 27. Steiner ME, Micheli LJ. Treatment of symptomatic spondylolysis and spondylolisthesis with the modified Boston brace. Spine (Phila Pa 1976). 1985;10:937-943.
• 28. Sinaki M, Lutness MP,Ilstrup DM, et al. Lumbar Spondylolisthesis: Retrospective Comparison and Three-Year Follow-Up of Two Conservative Treatment Programs. Arch Phys Med Rehabil. 1989;70:594-598.
• 29. Nava-Bringasa TI, Hernández-Lópeza M, Ramírez-Morab I. Effects of a stabilization exercise program in functionality and pain in patients with degenerative spondylolisthesis. J Back Musculoskelet Rehabil. 2014;27:41- 46.
• 30. Gündüz OH, Erçalık T. Kronik Bel Ağrısında Egzersiz Reçeteleme. Turk J Phys Med Rehab. 2014;60 (Suppl.2):25-30.
• 31. O’Sullivan PB. Evaluation of Spesific Stabilizing Exercise in the Treatment of Chronic Low Back Pain With Radiologic Diagnosis of Spondylolysis or Spondylolisthesis. Spine.1997;22:2959-2967.
• 32. Hardwick D, Tierney D, Fein C, et al. Outcomes of strengthening approaches in the treatment of low-grade spondylolisthesis. Physical Therapy Reviews. 2012;17:284-291.
• 33. Hu SS, Tribus CB, Diab M, et al. Spondylolisthesis and Spondylolysis.J Bone Joint Surg Am.2008;90:656-671.
• 34. Weinhoffer SL, Guyer RD, Herbert M, et al. Intradiscal pressure measurements above an instrumented fusion: A cadaveric study. Spine (Phila Pa 1976). 1995;20:526-531.