Spondylolisthesis – a state of the vertebrae , wherein the top is displaced relative to the lower anterior , or posterior direction. Moreover, the elderly frequency of spondylolisthesis is 25 – 29 % of all diseases of the spine and cause a high disability and significant impairment of quality of life .
The following types of spondylolisthesis :
– Dysplastic ;
– Isthmic or cervical ( spondilolitichesky ) ;
– Degenerative ( senile ) ;
– Traumatic ;
– Pathological (tumor , osteomyelitis ) .
Distinguished by the mechanism of displacement as front , rear and lateral , true and false , without complications, complications , asymptomatic and symptomatic .
According to clinical and radiological manifestations are divided into :
1 degree – the displacement of the vertebral body on the surface of ?;
Grade 2 – by ?;
Grade 3 – to ?;
4 degree – the entire surface of the vertebral body.
Depending on the stage of clinical course of the disease is divided into : Stage 1 – the beginning of sliding , 2 stage – the progression of the skid; Stage 3 – termination of slipping.
Spondylolisthesis clinically manifested :
– Pain localized in the lumbar or lumbosacral region , appearing spontaneously and is often worse while sitting , standing and walking , or provoked by compression , tapping the L5 spinous process or inclinations ;
– A distinct ridge in the form of a threshold in the spinous process of L5 vertebra in the spine by moving forward above the specified location ;
– The formation of the deepening of the spinous process of the L5 vertebra due to movement of the spine above this point forward ;
– Limitation of motion in the lumbar spine , tilt , especially forward until its complete impossibility ;
– radicular pain syndrome.
Radiological findings revealed a gap ( lytic ) in mezhotrostkovoy of the vertebral arch or inclined position of the articular processes of the vertebrae involved in slipping , slipping vertebra to form excessive lordosis in the horizontal position of the sacrum.
In the early stages of the disease or clinical symptoms unexpressed pokazanokonservativnoe treatment. This assignment of drugs (mainly non-steroidal anti-inflammatory drugs , vitamins, analgesics , corticosteroids , etc.), fizmetodov treatment , massage, exercise , swimming.
With failure of conservative treatment (when the pain persists , which makes it difficult to work or degrades the quality of life) , showing surgical treatment.