Figure 1: Investigation of disk intensity on mri. The number shows frequencies. Figure 2: Investigation of type of herniation on mri. Figure 3: Investigation of Modic change on mri. Figure 4: Investigation of existence of fluid or air in disk on mri. Figure 5: Investigation of facet tropism on mri. Figure 6: Investigation of hypertrophy of ligament flavum on mri. Figure 7: Investigation of level of disk involvement on mri.
Spondylolysis and, spondylolisthesis - orthoseek
Eighty five patients with spondylolisthesis enrolled to the study. Eighty (94.1) was female and 5 (5.9) was male. The mean age was.29.84 (Max 75, min 28). Investigation of disk intensity is shown in myself Figure. Investigation of type of herniation showed that more patients had protrusion (Figure 2). Investigation of modic changes is shown in Figure. From 85 patients more patients had no air or fluid in facet joint (Figure 4). More than half of patients had facet tropism and.2 of patients had hypertrophy of ligament flavum (Figure 5,6). All the patients had spondylolisthesis grade 1, in more patients the level of involvement was L4-L5 and had degenerative spondylolisthesis (Figure 7,8). Investigation of disk height showed that more patients had normal height (Figure 9) and there was no relation between disk height and disk intensity (p-value.40). There was no relation between facet tropism and hypertrophy of ligament flavum (p-value.26).
Written informed consents were obtained from patients before enrollment. In this retrospective study all patients with Spondylolisthesis that diagnosed by functional x-ray but without report house of it at radiologist note enrolled to the study. All patients referred to us for lumbar disk herniation or canal stenosis by progressive neurological symptoms. We investigate age, gender, disk intensity, type of herniation, modic change, existence of fluid or air in facet joint, facet tropism, hypertrophy of ligament flavum, level of spondylolisthesis, type and grade of spondylolisthesis and height of disk on mri at admission. Exclusion criteria: patients with lumbar trauma, patients with past surgical history, patients with lumbar deformities. Statistical analysis, kruskal Wallis h and Mann Whiteny u (categorical data) were used for comparisons analysis. Statistical analysis was performed using spss software (USA). P value.05 was regarded statistically significant.
In isthmic spondylolisthesis displacement is due to defects in the pars interarticularis; however in Degenerative spondylolisthesis there is no defect in pars interarticularis. The first symptom in these patients is back pain that exacerbate with exercise 4,5. Mri is used commonly as first paraclinic test for evaluation of patients with back pain with or without radiculoapthy; however standard diagnosis is with lateral and felexion-extention graphy. Mri can show soft tissue such as neural elements, disk herniaition, annulus healthy defects, neoplastic or inflammation condition. In most cases mri is used for supine and this will allow it to glide vertebrae in the fall and along with being a vertebra diagnosis is not done correctly 7,8. The aim of this study is to investigate mri findings in patients with spondylolisthesis that diagnosed only with clinical findings. Methods and Materials, after being approved by the ethics committee of Tabriz university of Medical Sciences, this descriptive study was performed in neurosurgery department in a 24 month period of time (January 2013-december 2015).
Keywords: Spondylolisthesis; Modic change; Disk height; mri. Abbreviations, cT: Computed Tomography; mri: Magnetic Resonance Imaging; pet: Positron Emission Tomography. Introduction, spondylolisthesis fused by a belgium gynecologist about 200 years ago at first. Spondylolisthesis means glide to vertebrae on the lower one. This word is derived from two Greek word; Spondylos means vertebrae and listhesis means glide. Spondylolisthesis is a common disorder in lumabar vertebras and consist of more than 30 of lumbar fusions are diagnosed. Spondylolisthesis is divided to 5 groups: Dysplastic, Isthmic, degenative, traumatic and pathologic. Degenerative spondylolisthesis is seen more in women at level L4- L5 however isthmic spondylolisthesis is seen in men at level L5-S1.
Spondylolisthesis : Back pain causes, symptoms
Degenerative spondylolisthesis is the seen more in women at level L4-L5 however isthmic spondylolisthesis is seen in men at level L5-S1. Mri is used commonly as first paraclinic test for evaluation of patients with back instant pain with or without radiculoapthy. It is used in supine position commonly that this cause glide at the reduced rate and along with a placement. This has to be misdiagnosed of Spondylolisthesis. The aim of this study is to investigate the mris of patients with Spondylolisthesis to explain the findings on mri in these patients. Methods and Materials: In this retrospective study all patients with spondylolisthesis that diagnosed by functional x-ray without report of radiologist note from January 2013 - january 2015 enrolled to the study.
Results: All the 85 patients have spondylolisthesis Grade 1 on mri. Height of Disc, type of herniation, modic changes, existence of fluid or air in facet joint and existance of tropism in facet joint was investigated. Investigation of facet joint hypertrophy and facet tropism demonstrate no significant relation. Investigation of height of disc and disc intensity demonstrate no significant relation too. Conclusion: Based on findings of this study we can realized that more patients with spondylolisthesis grade 1 on mri misdiagnosed and this study help neurosurgeons to be suspected to spondylolisthesis with investigation of factors simultaneous such as disc protrusion, facet joint topism and flavum ligament.
Natural history of symptomatic isthmic low-grade spondylolisthesis in children and adolescents: a seven-year follow-up study. Long-term clinical and radiological follow-up of spondylolysis and spondylolisthesis. Seitsalo s, osterman k, hyvãrinen h, tallroth k, schlenzka d, poussa. Progression of spondylolisthesis in children and adolescents. A long-term follow-up of 272 patients. Progression of lumbosacral isthmic spondylolisthesis in adults.
Osterman k, schlenzka d, poussa m, seitsalo s, virta. Isthmic spondylolisthesis in symptomatic and asymptomatic subjects, epidemiology, and natural history with special reference to disk abnormality and mode of treatment. Clin Orthop Relat Res. Last updated uncollapseSections CcYqel 'ycYdul 'acyrul '-cydul 'a1YQ2l 'b1YH2l 'x1Y92l '11Y2fL). Lotfinia i1, daghighi mh2, salehpour F1, rezakhah A1, mirzaei f1, mahdkhah A1 and Naseri Alavi sa1* 1Department of neurosurgery, faculty of Medicine, tabriz university of Medical Sciences, tabriz, iran 2Department of Radiology, faculty of Medicine, tabriz university of Medical Sciences, tabriz, iran *Corresponding author: seyed. Abstract, introduction: Spondylolisthesis is a common disorder in lumabar vertebras and consist of more than 30 of lumbar fusions are diagnosed.
Understanding, your, mri of the, lumbar Spine - denver
Current concepts on the sagittal balance and classification of spondylolysis and spondylolisthesis. Revista Brasileira friendship de Ortopedia. Updated February 1, 2016. Accessed February 28, 2017. Lumbar Spondylolysis and Spondylolisthesis. In: Lumbar Spondylolysis and Spondylolisthesis. Updated February 18, 2016. Frennered ak, british danielson bi, nachemson.
Spondylolisthesis, Spondylolysis, and Spondylosis. In: Spondylolisthesis, Spondylolysis, and Spondylosis. New York, ny: WebMD. Updated February 3, 2017. Accessed February 16, 2017. Kalichman l, kim dh, li l, guermazi a, berkin v, hunter. Spondylolysis and spondylolisthesis: prevalence and association with low back pain in the adult community-based different population. Spine (Phila pa 1976).
a noticeable step-off at the lumbosacral area may be palpated or even seen when the patient is standing. Straight leg raise test : A straight leg raise with the patient lying on the back causes pain and therefore triggers elevation of the entire trunk (to relieve the pain ). Provocative test: The relief from pain after local injection of lidocaine at the level of the pars interarticularis may help confirm the diagnosis. Radiologic examination: Conventional x-ray of lumbosacral spine meyerding classification 5 stages: The amount of forward translation of the cranial vertebra over the caudal vertebra is measured in percentage on a lateral radiograph. Specific signs: Scotty dog with a collar sign in : normal appearance of the lumbar in an oblique projection at 45 is referred to as "Scotty dog sign" in, the line appears as the "dog's collar" Inverted Napoleon's hat sign in spondyloptosis: in the case. Treatment Conservative treatment Physical therapy emphasizing training of back and abdominal muscles Facet or epidural steroid injections to relieve radicular pain. Regular follow-ups every 6 months Surgical treatment Indication: high-grade spondylolisthesis ( 50 slippage of cranial vertebra over the caudal vertebra neurologic deficits, traumatic spondylolisthesis or if symptoms progress despite conservative treatment Standard procedure: vertebral fusion.
Most patients achieve good results with conservative treatment (e.g., physical therapy). Surgical treatment (e.g, vertebral fusion, decompression of the nerves) is reserved for patients with refractory cases and the neurologic deficits. Overall, children and adolescents achieve better results than adults and elderly. Epidemiology, most common in children years (congenital and spondylolytic form) and adults aged 50 years (degenerative form). Defect most commonly occurs in the lumbar spine (L5 in 80 of cases L4 in 15 of cases. Epidemiological data refers to the us, unless otherwise specified. Etiology, risk factors: Congenital malformation (dysplasia or hypoplasia) of the lumbosacral joints. S1, repetitive hyperextension and rotation movements. S1, commonly associated with gymnastics, swimming, and weight lifting.
Spondylolisthesis : everything you ever wanted to know
Clinical science, abstract, the term spondylolisthesis defines a condition in which the vertebral bodies slip forward in relation to the vertebrae beneath. Most commonly L5 slips over. The disease affects approx. 69 of the population. The condition most commonly occurs in children, adolescents, and in individuals 50 years old. Risk factors are repetitive hyperextension of the spine (e.g., gymnastics trauma, bone pathologies, or degenerative spine disease. Spondylolisthesis may be asymptomatic or cause lumbar pain on exertion, gait problems, radiculopathic pain, or urinary essay incontinence. In some patients a step-off at the lumbosacral area is palpable. Diagnosis is established through imaging.