Isthmic Spondylolithesis

Isthmic Spondylolithesis-18
It is characterized by a significant constriction of the cauda equina, combined with a diminished cross-sectional area of the vertebral canal, thickening and buckling of the ligamentum flavum and hypertrophy of adjacent facet joints.: • Disc degeneration;• Facet joint arthrosis;• Malfunction of the ligamentous stabilizing component;• Ineffectual muscular stabilization.Degenerative spondylolisthesis is believed to result from chronic intersegmental instability.

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Sagittal orientation of the facet joints and facet tropism also have been related to the development of degenerative spondylolisthesis.

Therefore, with an elongated pars, it is important to evaluate the lumbosacral facets to properly classify the lesion.• Type 2: Isthmic spondylolisthesis It is due to a lesion of the pars interarticularis and is a common source of pain and disability in both pediatric and adult population.

The basic lesion in isthmic spondylolisthesis is in the pars interarticularis and mainly appears at the lumbosacral level (L5-S1).

• In adult patients with radiculopathy, magnetic resonance imaging should be considered. MRI is suggested to identify neuroforaminal stenosis in adult patients with isthmic spondylolisthesis . There is insufficient evidence to make a recommendation for or against the use of magnetic resonance imaging to differentiate isthmic versus degenerative spondylolisthesis in adult patients .

Grade of Recommendation: I (Insufficient Evidence)3. There is insufficient evidence to make a recommendation for or against the use of discography to evaluate adult patients with isthmic spondylolisthesis .

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