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Review
. 2014 Dec;8(6):856-63.
doi: 10.4184/asj.2014.8.6.856. Epub 2014 Dec 17.

Lumbar spondylolysis and spondylolytic spondylolisthesis: who should be have surgery? An algorithmic approach

Farzad Omidi-Kashani  1 , Mohamad Hossein Ebrahimzadeh  2 , Saman Salari  3
Affiliations
Review

Lumbar spondylolysis and spondylolytic spondylolisthesis: who should be have surgery? An algorithmic approach

Farzad Omidi-Kashani et al. Asian Spine J. 2014 Dec.

Abstract

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.

Keywords: Lumbosacral Region; Spondylolisthesis; Spondylolysis; Surgical Procedures.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
(A, B) Oblique lumbosacral views of a normal and abnormal spine, respectively, for detection of a broken neck or a collar in the Scotty dog (C). The ear (1) is the superior articular process, the eye (2) is the pedicle, the nose (3) is the transverse process, the neck (4) is the pars interarticularis, and the frontal limb (5) is the inferior articular process.
Fig. 2
Fig. 2
A 13-year-old girl presented with acute low back pain after a sport accident. On plain radiographies (A) and (B) L4 spondylolysis is suspicious. Single photon emission computed tomography scanning (C) shows bilateral increased tracer uptake in the posterior neural arc of L4 vertebra (arrows).
Fig. 3
Fig. 3
An algorithmic approach to a patient with lumbar spondylolysis. ADL, activity of daily living.
Fig. 4
Fig. 4
A 17-year-old adolescent with L4-5 spondylolisthesis. Note the difference between the amount of slippage in the supine magnetic resonance imaging compared to the standing lateral view of the lumbosacral area (20% vs. 40%).
Fig. 5
Fig. 5
An algorithmic approach to a patient with lumbar spondylolisthesis. ADL, activity of daily living.
See this image and copyright information in PMC

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