The question of whether not to have surgery for isthmic spondylolisthesis is a very good one. When a patient has a stress fracture in the spine (spondylolysis) which is bilateral, and then one vertebral body slips on the one below, that is termed isthmic spondylolisthesis. Once the initial stress fracture occurs, which is termed spondylolysis, the patient will often end up with pain, however surgery for for simple spondylolysis is by and large not a very good idea.

Surgery could be necessary in unusual circumstances for spondylolysis, however, typically it is dealt with effectively with conservative management. If the stress fracture refuses to heal and eventually stops trying, then you may end up with the vertebral body slipping forward as the back part stays put, and what one sees is the vertebral body slipping ahead over the one below, termed spondylolisthesis.

In order to see whether surgery is indicated for spondylolisthesis, a decision needs to be made as to the slippage degree. A Grade One slip is defined as the vertebral body on top slipping between zero and 25% compared to the vertebral body below. A Grade 2 Slip means the vertebral body slipped forward twenty five to fifty percent and Grade 3 is seventy five to one hundred percent of one vertebral body over the one below. A Grade Five is over 100%, and this is actually called spondyloptosis.

Studies have shown that by the time a patient is seen with a spondylolisthesis that has slipped and is symptomatic, the patients slippage has achieved 90% of that which you will ever slip. Research studies for isthmic spondylolisthesis have shown that spine surgery is indicated for slippages over a Grade 2. So if it’s a Grade Three or Grade Four then surgery is indicated in order to alleviate the patient symptoms and prevent further slippage from occurring.

Whether or not to manually decrease the slip intra-operative is questionable, however, what’s not so controversial is that the affected levels should be fused and the symptomatic nerve roots under traction should be decompressed.

If an individual has a Grade 1 or Grade 2 slip, then spine surgery is indicated only if arizona pain management conservative treatments fail. This could include physical therapy, phoenix chiropractor treatment, spinal bracing, TENS machines, and pain management.

 

The Basics Of Treatment For Isthmic Spondylolisthesis

Isthmic Spondylolisthesis Video | Stress Fracture of the Back Vertebra | Spine Surgeon Colorado

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