Spondylolisthesis is slipping part of the vertebral column over the column below it. This is usually defined as slipping of one vertebra over another, which is actually not that simple.
No vertebra moves individually in the spinal column. In the following figure you can see the vertebra at the level of pathology being L5.
Here all the bones attached to L5 which lie above it move forwards along with it and the sacrum and pelvis lags behind.
This condition is divided in to many types. Basically they can be defined as that which occurs during development and the one’s which are acquired.
Symptoms are usually back pain, tightness of the thigh muscles and posture problems in the developmental ones. In degenerative type of spondylolisthesis, difficulty in walking, calf pain and weakness or numbness of the feet are seen. X-rays and MRI scans help to diagnose the condition.
Most of them can be managed conservatively. Mild varieties usually are treated with lumbosacral belt, rest for a short period and mild analgesics. Severe varieties need surgery when they do not respond.
These are usually treated with special titanium screw cage constructs. The aim of the surgery is to prevent further progression and relieve the neurological deficits.
shows a high grade developmental spondylolisthesis which was operated with special titanium screws.
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