• Title/Summary/Keyword: Degenerative spondylolisthesis

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Degenerative Spondylolisthesis in Thoracic Spine

  • Kim, Eui-Hyun;Kuh, Sung-Uk;Cho, Yong-Eun;Kim, Young-Soo
    • Journal of Korean Neurosurgical Society
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    • v.37 no.4
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    • pp.313-315
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    • 2005
  • A 66 year-old woman was admitted to our hospital for progressive weakness of both lower extremities since a month ago. Imaging study, based on plain X-ray, computed tomography and magnetic resonance image revealed spinal stenosis owing to anterior slipping of T10/11 segment. Degenerative spondylolisthesis is common in the lumbar spine and rarely occurs in the cervical spine. But there was no report of degenerative spondylolisthesis in thoracic spine. The authors experienced a case of degenerative spondylolisthesis in the thoracic spine. And we achieved a satisfactory result with posterior decompressive laminectomy alone.

Magnetic Resonance Imaging Analysis of Intervertebral Disc Change of Several Spondylolisthesis Patients in Fifties : Comparison Lytic and Degenerative Spondylolisthesis (일부 50대 척추전방전위증 환자의 유형별 자기공명영상상 추간판 변형 형태 고찰)

  • Kim, Seok;Bahn, Hyo-Jung;Yoon, Hyun-Seok;Han, Kyung-Wan;Woo, Jae-Hyuk
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.6 no.2
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    • pp.13-22
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    • 2011
  • Objectives : The purpose of this study is to find out the characteristics of intervertebral disc changes and relative factors of the spondylolisthesis patients in fifties by type of spondylolisthesis. Methods : We investigated 69 cases of patients who visited one Korean traditional medicine hospital and were diagnosed as spondylolisthesis on L-spine X-ray and L-spine magnetic resonance imaging(MRI). We selected 37 lytic spondylolisthesis patients and 32 degenerative spondylolisthesis patients. We analysed the relativity between the numbers of changed discs, types of changed disc, locations of nerve compression and types of spondylolisthesis. Results : 1. The number of changed discs increase in lytic type, but there is no statistically significant difference. 2. Bulging disc is the dominant type of disc change. There is no significant difference between two types. 3. Both foraminal type was shown dominantly in lytic spondylolisthesis, diffuse type in degenerative spondylolisthesis by the analysis of the location of the nerve compression. But the symptoms of patients and dermatome did not match in most of the cases. Conculsions : The direction of nerve compression is different while the disc changing aspects are similar in both types. In several spondylolisthesis patients in fifties, symptoms of patient are related to degeneration of vertebrae, not to the type of spondylolisthesis.

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CT Study of Spondylolisthesis Comparison Between Isthmic and Degenerative Type (척추 전방전위증의 전산화 단층촬영 소견 : 협부형과 퇴행형의 비교)

  • Lee, Jong-Deok;Byun, Jae-Young
    • Journal of Acupuncture Research
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    • v.17 no.4
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    • pp.79-87
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    • 2000
  • Objectives : To evaluate the findings useful for differential diagnosis and associated abnormaiities of isthmic spondylolisthesis and degenerative spondylolisthesis on CT. Materials and methods : We reviewed retrospectively the CT images of 65 patients who were diagnosed spondylolisthesis during 3 years period. Our technique was 5mm slices at 5mm intervals with gantry angle to parallel the interspaces. Also reformatted sagittal views were taken. 41 patients were isthmic spondylolisthesis and 24 patients were degenerative spondylolisthesis. Resuits : Isthmic spondylolisthesis. 1. Isthmic type was more common at L5-S1. 2. The degree of anterior displacement was grade I and II. 3. The plane of defect was more horizontal than the usual facet joint. 4. The defect had an irregular shape. 5. Medial aspect of bone just anterior to defect had a small round prominence. 6. Anteroposterior elongation of the spinal canal was common. 7. Pseudobulging disk was common. 8. The most common associated abnormality was a HNP at the upper level of the defect. Degenerative spondylolisthesis. 1. Degenerative type was more common at L4-5. 2. The degree of anterior disptacement was grade I and II. 3. The Plane of facet joint was oriented obliquely instead of horizontally. 4. The posterior facet(inferior facet of superior vertebra) was anteriorly displaced. 5. Bony spur of the posterior portion of anterior facet was seen. 6. The facet joints often contain gas(vaccum phenomenum). 7. The most common associated abnormality was a HNP at the level of the displacement. Conclusions : CT is a highly accurate and most sensitive technique for recognition, differential diagnosis of isthmic and degenerative types and the detection of associated abnormalities.

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Concurrent Degenerative Cervical and Lumbar Spondylolisthesis (경추 및 요추 퇴행성 척추전위증의 병발성 유병률)

  • Park, Moon Soo;Hwang, Ji-Hyo;Kim, Tae-Hwan;Oh, Jae Keun;Chang, Ho Guen;Kim, Hyung Joon;Park, Kun-Tae;Lim, Jin Kyu;Riew, K. Daniel
    • Journal of Korean Society of Spine Surgery
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    • v.25 no.4
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    • pp.154-159
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    • 2018
  • Study Design: Retrospective radiographic study. Objective: To evaluate the characteristics of concurrent degenerative cervical and lumbar spondylolisthesis. Summary of Literature Review: Concurrent degenerative cervical and lumbar spondylotic diseases have been reported. Given that severe spondylosis can result in spondylolisthesis, one might expect that concurrent spondylolisthesis of the cervical and lumbar spines might also be prevalent. However, the incidence of spondylolistheses in the lumbar and cervical spines might differ due to anatomical differences between the 2 areas. Nonetheless, there is minimal information in the literature concerning the incidence of concurrent cervical and lumbar spondylolisthesis. Material and Methods: We evaluated standing cervical and lumbar lateral radiographs of 2510 patients with spondylosis. Concurrence, age group, gender, and direction of spondylolisthesis were evaluated. Lumbar spondylolisthesis was defined as at least Meyerding grade I and degenerative cervical spondylolisthesis was defined as over 2 mm of displacement on standing lateral radiographs. Results: Lumbar spondylolisthesis was found in 125 patients (5.0%) and cervical spondylolisthesis was found in 193 patients (7.7%). Seventeen patients had both degenerative cervical and lumbar spondylolistheses (0.7%). Lumbar spondylolisthesis is a risk factor for coexisting cervical spondylolisthesis. Lumbar spondylolisthesis was more common in females than males, independent of advancing age. In contrast, degenerative cervical spondylolisthesis was more common in older patients, independent of gender. Anterolisthesis was more common in the lumbar spine. Retrolisthesis was more common in the cervical spine. Conclusions: There was a higher prevalence of degenerative cervical spondylolisthesis in patients with degenerative lumbar spondylolisthesis.

Anatomic Consideration of Spondylolysis and Spondylolisthesis type (척추 분리증과 척추 전방 전위증의 분류에 따른 해부학적 특성)

  • Kim gi-won
    • The Journal of Korean Physical Therapy
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    • v.15 no.4
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    • pp.24-33
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    • 2003
  • Spondylolysis and spondylolisthesis are two conditions that directly involve changes in the vertebra. Spondylolysis is defined as a defect in the pars interarticularis, the region of the lamina between the superior and inferior articular facets. Progression of the defect can result in spondylolisthesis, which is defined as a subluxation or 'slippage' of two adjacent vertebrae. In the low back it occurs most commonly at the lumbosacral level; next in frequency is spondylolisthesis of the fourth lumbar vertebra on the fifth. To provide the reader with information about the aetiology and anatomical consideration of spondylolysis and spondylolisthesis type. Spondylolisthesis has recently been classified by Wiltse and others into five types based on the suspected aetiology; dysplastic, isthmic, degenerative, posttraumatic, pathologic and postsurgical. Of these five types, isthmic spondylolisthesi and degenerative spondylolisthesis, both of which are frequently associated with low back and lower limb pain.

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Consideration of Imaging Studies for Degenerative Spine Disease (퇴행성 요추질환 영상의 고찰)

  • Sin, Jung-Sub;Kim, Jae-Hun
    • Journal of the Korean Society of Physical Medicine
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    • v.2 no.1
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    • pp.93-99
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    • 2007
  • Purpose : The aim of this study is to consider degenerative spine disease theoretically and compare plain radiography which is a basic study for low back pain with MRI in cases of degenerative lumbar spine disease to find out whether the abnormalities agree with each other. Methods : In 4 cases of lumbar degenerative disease, we studied the relation of the abnormalities such as disc space narrowing, spinal space narrowing, loss of lordosis and osteophytes on plain radiography with those on MRI of HIVD, spinal stenosis and spondylolisthesis. Results : Many abnormalities such as disc space narrowing, spinal space narrowing, loss of lordosis, osteophytes and change of cortex & bone marrow on plain radiography suggest HIVD, spinal stenosis, spondylolysis or spondylolisthesis on MRI. Conclusion : For low back pain patients, plain radiography is a basic study in diagnosis of HIVD, spinal stenosis, spondylolysis or spondylolisthesis but MRI or CT scan is necessary to develop(build) a treatment plan like an operation.

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Clinical Studies on Spondylolisthesis (척추전방전위증(脊椎前方轉位症)에 대한 임상적(臨床的) 고찰(考察))

  • Han, Moo-Gyu;Jin, Jae-Do;Lee, Jeoung-Hoon;Lee, Seung-Woo;Han, Sang-Won
    • Journal of Acupuncture Research
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    • v.18 no.3
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    • pp.215-226
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    • 2001
  • Objective : Spondylolisthesis has become one of the major causes of the lower back pain in the orthopedic field. We wanted to compare the radiological change with before & after treatment including constitution-acupuncture on spondylolisthesis. Methods : This study were carried out on 9 patients with spondylolisthesis. We reviewed medical records and radiological films. We studied rating score, percent of slip, sagittal angle, percent of posterior disc height. Results and conclusions : The improvement index showed 0.04, 030, 033, 0.00, 0.32 points in isthmic type, and 0.55, 0.56, 0.53, 0.00 points in degenerative type. The percent of slip for pre/post-treatment showed 20/20, 12/11, 24/20, 30/30, 4/3 percents in isthmic type, and 12/4, 16/11, 13/9, 8/8 percents in degenerative type. Sagittal angle showed 11/11, 15/12, 21/18, 17/15, 21.19 degrees in isthmic type, and 22/21, 19/15, 2/2, 8/9 degrees in degenerative type. Percent of posterior disc height were 17/18, 26/28, 24/25, 22/23, 25/27 in isthmic type, and 29/33, 37/45, 25/31, 24/24 in degenerative type. The result suggest that constitution-acupuncture and conservational treatment are good method for treatment of spondylolisthesis, and especially in degenerative type.

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Clinical Study of the Treatment of Spondylolisthesis with Lumbar Herniated Intervertebral Disc (요추 추간판 탈출증을 동반한 척추전방전위증의 한방치료에 관한 임상적 고찰)

  • Kim, Tae-Ho;Yoon, Tae-Kyung;Yun, Young-Ung;Jeong, Seon-Yeong;Lee, Cha-Ro
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.9 no.1
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    • pp.15-26
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    • 2014
  • Objectives : The purpose of this study was to evaluate the effect of Korean medicicine treatment in patients with Spondylolisthesis and Lumbar Herniated Intervertebral Disc(HIVD). Methods : This clinical study was carried out on 62 patients who were diagnosed as spondylolisthesis and lumbar herniated intervertebral disc(HIVD) on L-spine X-ray and L-spine magnetic resonance imaging(MRI), who had been admitted from Feb. 2013 to Apr. 2014. All of 62 patients were treated with acupuncture, chuna treatment and herbal medicine during the whole admission period. Numerical rating scale(NRS) was used to evaluated the effectiveness of the oriental medical treatment. Results : 1. Distribution showed female predominance in general. 2. Degenerative type is the most common in this study. 3. In the duration of symptoms, the largest group was" Subacute"(32.26%). 4. Almost of patients had radiation pain, but in SLR test and valsalva test, more patients had no significant sign. 5. Spondylolytic type involved the 5th lumbar vertebra in 80% and degenerative type involved the 4th lumbar vertebra in 53.84%. 6. Most of case were grade 1(93.54%) in degree of slipping. 7. By the oriental medical treatment, NRS reduction in spondylolytic spondylolisthesis, was better than degenerative spondylolisthesis. Conclusions : The result of treatment by Korean medical is satisfactory for the tretment of spondylolisthesis.

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Comparison of Sagittal Spinopelvic Alignment between Lumbar Degenerative Spondylolisthesis and Degenerative Spinal Stenosis

  • Lim, Jae Kwan;Kim, Sung Min
    • Journal of Korean Neurosurgical Society
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    • v.55 no.6
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    • pp.331-336
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    • 2014
  • Objective : The purpose of this study was to evaluate the differences in sagittal spinopelvic alignment between lumbar degenerative spondylolisthesis (DSPL) and degenerative spinal stenosis (DSS). Methods : Seventy patients with DSPL and 72 patients with DSS who were treated with lumbar interbody fusion surgery were included in this study. The following spinopelvic parameters were measured on whole spine lateral radiographs in a standing position : pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis angle (LL), L4-S1 segmental lumbar angle (SLL), thoracic kyphosis (TK), and sagittal vertical axis from the C7 plumb line (SVA). Two groups were subdivided by SVA value, respectively. Normal SVA subgroup and positive SVA subgroup were divided as SVA value (<50 mm and ${\geq}50mm$). Spinopelvic parameters/PI ratios were assessed and compared between the groups. Results : The PI of DSPL was significantly greater than that of DSS (p=0.000). The SVA of DSPL was significantly greater than that of DSS (p=0.001). In sub-group analysis between the positive (34.3%) and normal SVA (65.7%), there were significant differences in LL/PI and SLL/PI (p<0.05) in the DSPL group. In sub-group analysis between the positive (12.5%) and normal SVA (87.5%), there were significant differences in PT/PI, SS/PI, LL/PI and SLL/PI ratios (p<0.05) in the DSS group. Conclusion : Patients with lumbar degenerative spondylolisthesis have the propensity for sagittal imbalance and higher pelvic incidence compared with those with degenerative spinal stenosis. Sagittal imbalance in patients with DSPL is significantly correlated with the loss of lumbar lordosis, especially loss of segmental lumbar lordosis.

Posterior Lumbar Interbody Fusion Versus 360° Fixation in Degenerative Lumbar Diseases (퇴행성 요추 질환에서 후방경유 추체간 유합술과 360° 고정술의 비교)

  • Lee, Nok Young;Oh, Seong Hoon;Rhee, Woo Tack;Bae, Jae Seong;Yi, Hyeong Joong;Kim, Young Soo;Ko, Yong;Kim, Kwang Myung;Oh, Suck Jun
    • Journal of Korean Neurosurgical Society
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    • v.30 no.10
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    • pp.1193-1199
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    • 2001
  • Objectives : The goal of operation for degenerative lumbar diseases is to relieve radiculopathy and low back pain and to prevent further degeneration. The authors analyzed the surgical results of posterior lumbar interbody fusion(PLIF) and $0^{\circ}$ fixation to evaluate the proper treatment policy in spinal stenosis, degenerative spondylolisthesis and low grade isthmic spondylolisthesis. Material and Methods : The authors performed PLIF on 92 patients and $0^{\circ}$ fixation on 138 patients with spinal stenosis, degenerative spondylolisthesis and low grade isthmic spondylolisthesis. We retrospectively studied clinical outcomes and subjective satisfaction of these patients by several criteria such as visual analog scale(VAS), Prolo's economic and functional outcome scale, medication usage after operation and questionaire for overall outcome. Result : Pre- and postoperative VAS on back pain and leg pain showed decrease of pain from 6.5, 6.7 to 2.2, 2.4 in PLIF group and from 7.0, 7.2 to 2.5, 2.7 in $0^{\circ}$ fixation group. Excellent and good outcomes on Prolo's scale were 81.5% in PLIF group and 82.6% in $0^{\circ}$ fixation group. Medication usage after operation was reduced in 79.3% of PLIF group and in 78.3% of $0^{\circ}$ fixation group. Patients' self-reported overall success of their procedure showed 82% in PLIF group and 84% in $0^{\circ}$ fixation group. Conclusion : Both PLIF and $0^{\circ}$ fixation showed good outcomes and provided biomechanically stable fusion in spinal stenosis, degenerative spondylolisthesis and low grade isthmic spondylolisthesis. Therefore, only PLIF seems necessary and considered a proper surgical treatment for these disorders.

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