No abstract available.
Spondylolysis*

Lumbar interbody fusion provides the most logical solution to diseases of the lumbar spine instabilities, such as spondylolysis, spondylolisthesis and retrolisthesis. The 33 cases of lumbar interbody fusion done after Cloward method, Wiltberger method, method using bovine bone employing Cloward technique, and anterolateral approach were analyzed. Posterior interbody fusion after Wiltberger technique using dowel bone graft is a more simplified method, providing accurate approximation of graft and host bone and preventing extrusion of graft then Cloward technique. Immediate correction of extruded graft if any after postoperative CT checking is essential for successful fusion.
Logic ; Spine ; Spondylolisthesis ; Spondylolysis ; Transplants

Multiple spondylolytic spondylolisthesis is very uncommon, and surgical reports are also scarce. This study describes the clinical characteristics, radiologic findings and surgical methods in 18 cases of multiple spondylolytic spondylolisthesis encountered by the authors between January, 1993 and December, 1996. Two hundred and thirty spondylolytic spondylolisthesis patients underwent surgery at this hospital during the same period, and in 18 of these, the spondylolysis was multiple, an incidence of 7.8%. There were 16 cases of two level spondylolyses, 15 of which were at L4+L5, and one case at the L3+L4 level, as well as two cases of three level spondylolyses, one at L2+L3+L4 and the other at the L3+L4+L5 level. All 18 cases showed spondylolisthesis at L4/5 and two showed two-level spondylolisthesis at L4/5 and L5/S1. A decompressive laminectomy(Gill operation) was performed in all cases and in addition, two level 360degreesfixation with pedicle screws and PLIF with cages was applied in 16 cases, and two level PLIF with cages in the other two. All showed good post-operative results. In conclusion, the condition was more common in females and bilateral L4 and L5 pars interarticularis defect and L4/5 spondylolisthesis were more common. Decompressive laminectomy(Gill operation) and two level 360degreesfixation with pedicle screws and PLIF with cages was found to be an effective operative choice.
Female ; Humans ; Incidence ; Spondylolisthesis* ; Spondylolysis

Unilateral pedicle stress fracture accompanying spondylolytic spondylolisthesis is rare even in the elderly. Most are associated with major trauma, previous spine surgery, or stress-related activity. Here, the authors describe an unique case of unilateral pedicle fracture associated with spondylolytic spondylolisthesis at the L5 level, which was successfully treated by posterior lumbar interbody fusion with screw fixation at the L5-S1 level. As far as the authors' knowledge, no such case has been previously reported in the literature. The pathophysiological mechanism of this uncommon entity is discussed and a review of relevant literature is included.
Aged ; Fractures, Stress ; Humans ; Spine ; Spondylolisthesis* ; Spondylolysis

Cervical spondylolysis is a rare vertebral anomaly defined as a corticated cleft between the superior and inferior articular pillar, the cervical equivalent of the pars interarticularis in the lumbar spine. Recognition of this anomaly and differentiation from acute traumatic fractures is of great importance because this lesion is usually diagnosed in patients after minor trauma or as an incidental finding on routine radiographs. The authors present two cases of this anomaly.
Humans ; Incidental Findings ; Spine ; Spondylolisthesis ; Spondylolysis*

Lumbar spondylolysis and spondylolisthesis are common spinal disorders that most of the times are incidental findings or respond favorably to conservative treatment. In a small percentage of the patients, surgical intervention becomes necessary. Because too much attention has been paid to novel surgical techniques and new modern spinal implants, some of fundamental concepts have been forgotten. Identifying that small but important number of patients with lumbar spondylolysis or spondylolisthesis who would really benefit from lumbar surgery is one of those forgotten concepts. In this paper, we have developed an algorithmic approach to determine who is a good candidate for surgery due to lumbar spondylolysis or spondylolisthesis.
Humans ; Incidental Findings ; Lumbosacral Region ; Spondylolisthesis* ; Spondylolysis*

OBJECTIVE: To analyze morphologic differences between only spondylolysis group and mild spondylolisthesis one in young-aged persons and to find useful parameters for radiological assessment of mild spondylolisthesis. METHOD: Twenty patients with only lumbar spondylolysis, 18 patients with mild lumbar spondylolisthesis and 19 normal subjects were recruited in this study. Their radiological findings were examined. The films of subjects were evaluated with respect to variables describing wedging of the spondylolytic vertebra, relative thickness and lengths of the transverse processes. The evaluation was made with attention to possible signs which could mean vertebral slipping. The lumbar index reflects the degree of wedge deformity of the spondylolytic vertebra. RESULTS: Lumbar index was significantly lower in spondylolisthesis group than only spondylolysis group. There was no significant difference in relative thickness of L5 transverse process between two groups. The incidence of a midline lumbar or sacral defect in the spondylolisthesis group was higher than other groups. CONCLUSION: Our results support the usefulness of lumbar index as a supplement parameter for radiological assessment of mild spondylolisthesis.
Congenital Abnormalities ; Humans ; Incidence ; Spine ; Spondylolisthesis* ; Spondylolysis

Three main types of operative teehnique are in general use today in the treatment of spondylolysis or spondylolisthesis: namely, total laminectomy alone, total laminectomy and posterior fusion, and anterior interbody fusion. According to Hoover(1968), above operations have yielded satisfactory results in approximately 70% of the cases. In recent years, Watkins, Adkins and Rombold have independently reported their cxperience with posterolateral intertransverse fusion, which they claim is based on a more sound mechanical basis and has yielded better results. The author performed anterior interbody fusion in 4 cases and posterolateral intertransverse fusion in 3 cascs at Seoul Naval Hospital during the 2 year period from May 1968 through May 1970 The postoperative follow-up period was maximum one year and minimum six months. Only one casc of anterior interbody fusion has shown sound fusion, while all ihe three posterolateral intertransverse fusions with posterior H-graft have yielded sound fusion with satisfactory clinical improvement by six months after operation.
Follow-Up Studies ; Laminectomy ; Seoul ; Spondylolisthesis ; Spondylolysis

Spondylolisthesis, named by Kilian in 1854, is a major cause of low back pain and numerous methods were designed for its treatment. The 80 cases out of 132 spondylolysis and spondylolisthesis were analysed and evaluated the result cf their treatment. The results are summerized as follows. 1. The most common type of spondylolisthesis was isthmic type (58 cases, 72.5%). 2. The most common site of incidence was L5 and L4, L3 were next to it. 3. All of the dysplastic type were in L5, isthmic type were in L3, L4 and the degenerative type were most common in L4, and followed L5,L3 consecutively. 4. The 67 cases out of 80 were treated conservatively and rest of cases had operative care with six cases of anterior fusion and seven cases of posterior fusion. 5. The results of tretment was evaluated and graded more than good in all cases of operative care and 51 cases (76.2%) in conservative management.
Incidence ; Low Back Pain ; Spondylolisthesis ; Spondylolysis

Since Hadra first used metalic internal fixation in the human spine with wire loop in 1895, various implants have been used. Knodt rod was designed on the principle that the distraction produced a localized flexion attitude in the area to be fused, thus increasing the size of the intervertebral foramina and decreasing the risk of intraforaminal encroachment on the nerve root. We have performed the posterolateral fusion with or without Knodt rod as a primary procedure in spondylolysis and spondylolisthesis of lumbar spine, which required arthrodesis of more than one level. For period of 8 1/2 years' from Sep. 1977 to Apr. 1986, 12 cases of diseased spine were treated with posterolateral fusion without Knodt rod, and 13 cases were treated with posterolateral fusion using Knodt rod. We compared with two groups, and the following results were obtained. 1. Solid bony fusion was 100% in posterolateral fusion with Knodt rod, and 92% without Knodt rod. 2. An average period of post-operative immobilization was 2 months in cases with Knodt rod, and 2.5 months without Knodt rod. 3. In posterolateral fusion with Knodt rod, 4 cases with the root symptoms were all improved. In posterolateral fusion without Knodt rod, 6 cases with root symptoms, were all improved. But in 1 case without the root symptoms, developed the root symptoms. 4. No significant changes in radiologic evaluation were found between posterolateral fusion with Knodt rod and without Knodt rod. 5. Post-operative complications developed in 4 cases (31%) with Knodt rod, and 6 cases (50%) without Knodt rod. 6. Clinically, the satisfactory results were 100% with Knodt rod, and 83% without Knodt rod.
Arthrodesis ; Humans ; Immobilization ; Spine ; Spondylolisthesis ; Spondylolysis