Ortiz RF, de la Torre GDM, González HFJ, Aguilar AM

Language: Spanish
References: 11
Page: 32-35
PDF size: 140.28 Kb.

ABSTRACT

Introduction. Isthmic spondylolisthesis occurs 4 to 8% of the population, the most common of spondylolisthesis. The lumbosacral joint has a weak spot in the region of inclination of the upper platform of the sacrum. Slipped to fifth vertebra above is prevented by the processes of L5 on S1, intervertebral disc, ligament and posterior arch system of L5. Materials and methods. Prospective, longitudinal, observational, in January 1994 to December 2009, with a total of 208 patients diagnosed with spondylolisthesis L4- L5, L5-S1, grade II and III classification Meyerding (121 men and 87 women) , aged 50 to 80 years, average 65. Inclusion criteria: Diagnosis of spondylolisthesis L4-L5, L5-S1 isthmic variety of grade II-III Meyerding with narrow lumbar spinal canal syndrome, spinal instability and neurological damage. Exclusion criteria were previous surgery prior isthmic spondylolisthesis, spondylolisthesis grade I and without neurological involvement. Results. The treatment of choice for isthmic variety espondilolitesis is conservative, only those patients who continue to back pain and neurologic involvement underwent spinal surgery, it was that of 209 patients, 140 were surgically treated, of whom 91% back pain and the commitment nerve gave way, in another 6% gave discomfort in four months after surgery and the remaining 3% continued with annoyance. Conclusion. Variety isthmic spondylolisthesis in L4-L5, L5-S1 the best treatment is conservative, only surgically treated patients who did not respond to conservative and continue with data from neurologic involvement, with Oswestry disability index of 40% or more. Proper release of the spinal canal, discectomy, foraminotomy and stabilization of the spine to achieve a 360 degree fusion is fundamental to good clinical outcome.

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