DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20151536

Incidence, diagnosis and management of adult cases presenting with symptomatic lumbar spondylolisthesis in a tertiary care hospital

Masroor Alam, Wasim Bari, Saif Omar

Abstract


Background: Five lumbar vertebrae bridge between the thoracic and the sacral. The first four are typical in nature and the fifth is of a standalone atypical variety. Normal inward curvatures are observed in both cervical and lumbar regions of the vertebral column. These lordotic curvatures usually help in shock absorption and support the weight of the head. Spondylolisthesis occurs when one vertebra slips forward over the vertebra below it. This condition usually develops in the lumbar region of the vertebral column. It is due to the lumbar spine being exposed to directional pressures while carrying and distributing most of the body weight during activity and at rest. Such a combination of weight bearing and multidirectional movement may cause forward slippage of any random lumbar vertebra over the vertebra beneath it. The aim of this study was to observe retrospectively adult male and female cases presenting with spondylolisthesis in the outdoor clinic of the Department of Orthopaedics in a tertiary care hospital.

Methods: Adult cases of either sex presenting with low back pain were clinically and radiologically investigated. Data regarding age, sex and occupation were recorded.

Results: The incidence of symptomatic spondylolisthesis was reported to be 211 out of 5117 cases that presented with low back pain. We observed that majority of cases were in the age group of 23 to57 years with higher preponderance among males. A small fraction of presenting cases were advised for laminectomy.

Conclusions: Incidence of symptomatic lumbar spondylolisthesis was high. Sex ratio among presenting cases was observed to be higher in males. Cases were clinically examined and diagnosed radiologically. Most cases were managed conservatively.


Keywords


Laminectomy, Lordotic, Lumbar, Slippage, Spondylolisthesis, Vertebra

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References


Canale TS. Campbell’s Operative Orthopaedics, Vol-II, 12th ed. Canada: Elsevier-Mosby; 2013:1839.

Ganju A. Isthmic spondylolisthesis. Neuorosurg. Focus. 2002;13:1-6.

Kuubiere CB. Incidence of symptomatic spondylolisthesis in Northern Ghana. Al Ameen J Med Sci. 2005;8(4):254-8.

Gibson JNA. Surgery for degenerative lumbar spondylosis. Spine. 2005;30(20):231-5.

Metsunaga S. Natural history of degenerative spondylolisthesis. Pathogenesis and natural cause of the slippage. Spine. 1990;15(11):1204-10.

Sengupta DK. Degenerative spondylolisthesis; Review of current trends and controversies. Spine. 2005;30(6 Suppl):71-81.

Ikuta K. Short term results of microendoscopic posterior decompressionfor lumbar spinal stenosis. J Neurosurg Spine. 2005;2(5):624-33.

Rahman M. Comparison of techniques for decompressive laminectomy; the minimally invasive versus the classic open approach. Minimally Invasive Neurosurg. 2008;51(2):100-5.

Atlas SJ. Long term outcomes of surgical and non-surgical management of lumbar spinal stenosis. Spine. 2005;30(8):936-43.

Lee CK. Lumbar spinal instability after extensive posterior spinal decompression. Spine. 1983;8(4):429-33.

Kalichman L. Diagnosis and conservative management of degenerative lumbar spondylolisthesis. Eur Spine J. 2008;17:327-35.

Rowe GG. The etiology of separate neural arch. J Bone Joint Surg Am. 1953;35:102-10.

Scott JH. Inheritance and spondylolisthesis: A radiographic family survey. J Bone Joint Surg Br. 1979;61:301-5.

Sadiq S. Surgical management of spondylolisthesis overview of literature. Neurology India. 2005; 53(4):506-11.

Martin CR. The surgical management of degenerative lumbar spondylolisthesis: a systematic review. Spine. 2007;32(16):1791-8.

Surin V. Degenerative lumbar spinal stenosis, result of operative treatment. Acta Orthop Scand. 1982;33(1):79-85.

Beutler WJ. Natural history of spondylosis and spondylolisthesis: a 45year follow up evaluation. Spine. 2003;28(10):1027-35.

Wiltse LL. Spondylolisthesis: Classification and aetiology. Symposium of the spine. Am Acta Orthop Surg. 1969:143.

Grobler LJ. Classification of operative and non-operative treatment of spondylolisthesis. In: Frymoyer’s The Adult Spine: Principle & Practice. 2nd ed. Philadelphia. Lippincott. 1997:1865-921.

Mackay M. Degenerative lumbar spondylolisthesis, a prospective randomized study comparing decompressive laminectomy and arthrodesis with and without spinal instrumentation. Spine. 1997;22(24):2807-12.

Faldini C. Surgical Treatment of symptomatic degenerative lumbar spondylolisthesis by decompression and instrumented fusion. J Orthop Traumatol. 2007;8(3):128-33.

Baker D. The natural history of spondylosis and spondylolisthesis. J Bone & Joint Surg Br. 1979;61:301-5.

Albanese M. Family study of spondylosis and spondylolisthesis. J Paeditr Orthop. 1982;2:496-9.

Hammerberg KW. New concepts on the pathogenesis and classification of spondylolisthesis. Spine. 2005;30(Suppl):4-11.

Buck JE. Direct repair of the defect in spondylolisthesis with the modifies Boston brace. J Bone & Joint Surg Br. 1970;52:432-7.