Waist Slip (Adult Isthmic Spondylolisthesis)
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What is Adult Isthmic Spondylolisthesis?
The spine consists of interconnected bone structures called vertebrae. Approximately 5% of adults have a developmental fracture, which occurs mostly between the lower spine and the tailbone (sacrum). This crack may occur as a stress fracture. Due to the constant forces affecting the lower back, this fracture usually does not heal like a normal bone. Such a fracture is called spondylolysis and is a simple crack involving part of the vertebra and does not cause any serious problems. But sometimes the cracked vertebra slides forward over the vertebra below. This condition is called adult isthmicspondylolisthesis.
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It shows the crack and slippage behind the spine.
Apart from this type of spondylolisthesis, there are other types of spondylolisthesis; One of these is degenerative spondylolisthesis, which occurs due to slippage, inflammation of the small joints in the spine (arthritis) and deterioration of the disc structure.
What are the Symptoms?
Isthmic spondylolisthesis may not cause symptoms even years after the slip occurs. Symptoms seen include lower back and hip pain; numbness, pain, muscle tension, weakness in the legs (sciatica); These may include an increase in waist curvature or difficulty in walking. Although these symptoms may be temporarily relieved with rest, they often increase with standing, walking, and other activities. Studies have shown that 5-10% of patients who see a spine surgeon with low back pain have spondylolysis or isthmic spondylolisthesis.
However, since isthmic spondylolisthesis is not always painful, seeing a crack (spondylolysis) or slippage (spondylolisthesis) on the x-ray does not mean that these are the source of your complaints.
How is it diagnosed?
After your doctor listens to your complaints and performs a physical examination, your lower back may directly request an x-ray. In most cases, it is possible to detect a crack or slippage with an x-ray. Sometimes some additional tests may be required. A computed tomography scan of your lower back may show a crack or defect in the bone. It also covers the soft tissues of the spine (nerve structures and discs between the vertebrae) and the cracks or cracks of these tissues. If there is a magnetic resonance imaging (MRI) may be requested to clearly show its relationship with the shear area. MRI can also detect the presence of any disc that is damaged or bursting due to spondylolisthesis (slip).
If isthmicspondylolisthesis is present, it is classified as grade I, II, III, IV depending on the size of the slip.
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Direct radiography: Significant mobility is observed in the L4-5 range with backward and forward bending.
What are the Treatment Methods?
If your doctor thinks that the cause of your pain is spondylolisthesis, he will usually try non-surgical treatment methods first. These methods include short-term bed rest, anti-inflammatory medications (orally or by injection) to reduce your lameness, painkillers to control your pain, braces to restrict movement, and physical therapy methods and exercise to improve your flexibility and strength. This way you can return to a more normal lifestyle. If rest is recommended, you should lie down for as long as your doctor deems appropriate. Usually this period is not longer than a few days (absolute bed rest is often not necessary). Ask your doctor when you can return to work during your treatment.
Your doctor may also provide training, sometimes with the help of a nurse or physiotherapist, on how you should do your daily activities
without straining your back.
If medication and physical therapy If the desired improvement is not observed as a result of the treatment, your doctor may request some additional new tests to obtain more detailed information.
The presence of a single vertebral fracture (spondylolysis) or intervertebral slippage (spondylolisthesis) in an adult does not create a dangerous situation. Therefore, treatment should aim to control pain and enable the patient to work. Although non-surgical treatment methods do not correct the crack or slippage, they can provide long-term pain control without the need for invasive methods. A comprehensive program may require three or four months of treatment.
Surgical Treatment
Surgical treatment is required in a very low percentage of patients whose pain does not relieve with non-surgical methods. Pain s� It may be caused by a pinched nerve, movement of an unstable fractured vertebra, or a nearby affected disc. If a spinal nerve is under pressure as a result of a slip, surgery is required to open a new tunnel or create an empty space for this nerve. As a result, stabilization with a screw and rod system is used to relieve the pressure on the nerve near a crack or slip. procedure or fusion (boiling of bones) may be recommended.
These procedures prevent the vertebrae from shifting further and also prevent new nerve pressures that may occur in this area. The success rate of fusion surgery in correcting the complaints of isthmicspondylolisthesis is over 75%.
When you can return to work after surgery varies depending on the job you do. If you have a desk job, you can return to work in as little as 2-3 weeks after surgery. If your job depends on physical strength, you may have to wait a few months for the bones to heal and heal. A full rehabilitation program is recommended after the operation so that you can return to your daily life activities.
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In the case of L4-5 slippage, it is seen that the slip was fixed with pedicular screws and the bone graft was placed between the vertebrae.
Notes About Adult Isthmic Spondylolisthesis
· A cracked vertebra (spondylolisthesis) is found in approximately 5% of adults and is usually painless.
· When the crack causes the vertebra to slip, the condition is called isthmic spondylolisthesis and is found in the lumbar and/or lower back. It may or may not cause leg pain.
· The first line of treatment is usually medication or physical therapy.
· Correct diagnosis and early treatment will enable your doctor to heal you faster with appropriate prescriptions.
· The majority of patients can achieve long-term well-being with non-surgical treatments.
· Medications should be used only as recommended and only as part of a comprehensive treatment program.
· Surgery may be necessary for persistent back and/or leg pain.
· The success rate of fusion surgery with or without nerve decompression is more than 75%.
Lumbar Slippage (Adult Isthmic Spondylolisthesis)
Image
What is Adult Isthmic Spondylolisthesis? ?
The spine consists of interconnected bone structures called vertebrae. Approximately 5% of adults have a developmental fracture, which occurs mostly between the lower spine and the tailbone (sacrum). This crack may occur as a stress fracture. Due to the constant forces affecting the lower back, this fracture usually does not heal like a normal bone. Such a fracture is called spondylolysis and is a simple crack involving part of the vertebra and does not cause any serious problems. But sometimes the cracked vertebra slides forward over the vertebra below. This condition is called adult isthmicspondylolisthesis.
Image
It shows the crack and slippage behind the spine.
Apart from this type of spondylolisthesis, there are other types of spondylolisthesis; One of these is degenerative spondylolisthesis, which occurs due to slippage, inflammation of the small joints in the spine (arthritis) and deterioration of the disc structure.
What are the Symptoms?
Isthmic spondylolisthesis may not cause symptoms even years after the slip occurs. Symptoms seen include lower back and hip pain; numbness, pain, muscle tension, weakness in the legs (sciatica); These may include an increase in waist curvature or difficulty in walking. Although these symptoms may be temporarily relieved with rest, they often increase with standing, walking, and other activities. Studies have shown that 5-10% of patients who see a spine surgeon with low back pain have spondylolysis or isthmic spondylolisthesis.
However, since isthmic spondylolisthesis is not always painful, seeing a crack (spondylolysis) or slippage (spondylolisthesis) on the x-ray does not mean that these are the source of your complaints.
How is it diagnosed?
After your doctor listens to your complaints and performs a physical examination, your lower back may directly request an x-ray. In most cases, it is possible to detect a crack or slippage with an x-ray. Sometimes some additional tests may be required. A computed tomography scan of your lower back can detect cracks or broken bones. uk can show the structure. Additionally, magnetic resonance imaging (MRI) may be requested to clearly demonstrate the soft tissues of the spine (nerve structures and discs between the vertebrae) and the relationship of these tissues with the crack or slip area, if any. MRI can also detect the presence of any disc that is damaged or bursting due to spondylolisthesis (slip).
If isthmicspondylolisthesis is present, it is classified as grade I, II, III, IV depending on the size of the slip.
Image
Direct radiography: Significant mobility is observed in the L4-5 range with backward and forward bending.
What are the Treatment Methods?
If your doctor thinks that the cause of your pain is spondylolisthesis, he will usually try non-surgical treatment methods first. These methods include short-term bed rest, anti-inflammatory medications (orally or by injection) to reduce your lameness, painkillers to control your pain, braces to restrict movement, and physical therapy methods and exercise to improve your flexibility and strength. This way you can return to a more normal lifestyle. If rest is recommended, you should lie down for as long as your doctor deems appropriate. Usually this period is not longer than a few days (absolute bed rest is often not necessary). Ask your doctor when you can return to work during your treatment.
Your doctor may also provide training, sometimes with the help of a nurse or physiotherapist, on how you should do your daily activities
without straining your back.
If medication and physical therapy If the desired improvement is not observed as a result of the treatment, your doctor may request some additional new tests to obtain more detailed information.
The presence of a single vertebral fracture (spondylolysis) or intervertebral slippage (spondylolisthesis) in an adult does not create a dangerous situation. Therefore, treatment should aim to control pain and enable the patient to work. Although non-surgical treatment methods do not correct the crack or slippage, they can provide long-term pain control without the need for invasive methods. A comprehensive program may require three or four months of treatment.
Surgical Treatment
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