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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Five vertebrae with unilateral spondylolysis are presented. The associated asymmetry of the posterior elements supports the concept of a localised form of growth deficiency. The defect is difficult to demonstrate radiologically, and is perhaps present more frequently than is recognised. It should be suspected clinically from asymmetry of the neural arch and from unilateral wedging of the vertebral body, and may be demonstrated by further radiographic examination. The clinical significance is uncertain, but one patient is presented in whom unilateral spondylolysis was associated with intermittent sciatic pain.
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PMID:Unilateral spondylolysis. 709 2

The authors present the results of treatment of seven cases of spondylolysis with a two years follow up. Six patients were treated with the thoracolumbosacral orthosis and one with L5-S1 fusion. At the end of the follow up all patients were pain free.
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PMID:[Traumatic spondylolysis]. 781 4

Twenty-seven patients with spondylolysis and back pain were considered for spinal fusion. All patients underwent clinical evaluation, multiplanar computed tomography (CT) and single photon emission computed tomography (SPECT). After clinical evaluation 12 patients were not considered suitable for fusion on clinical grounds. SPECT was normal in these patients. Fifteen underwent a trial of lumbar immobilization and nine of those rendered pain free subsequently underwent spinal fusion. The results of clinical examination, lumbar immobilization, imaging and final outcome were compared in these patients. Those patients rendered pain free by surgery all had positive SPECT scans. Those with persistent pain after surgery had negative scans. This small series suggests a positive relationship between SPECT scanning and patient outcome following fusion. These findings need to be confirmed by larger studies with longer periods of follow-up.
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PMID:Symptomatic spondylolysis: correlation of CT and SPECT with clinical outcome. 800 4

Seventeen patients with spondylolysis and minimal spondylolisthesis were treated with a Morscher hook screw and bone grafting. At follow up, 82% had no symptoms and radiographs confirmed fusion of the isthmic defect. One patient had occasional pain, and two had an unsatisfactory result. They were both over 25 years of age and had a moderate displacement of 3-4 mm.
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PMID:Surgical treatment of spondylolysis and spondylolisthesis with a hook screw. 802 Oct 74

We report the outcome of 71 consecutive posterolateral lumbar fusions without spinal instrumentation. The indication for the operation was spondylolysis-olisthesis, degenerative disc disease/facet joint arthrosis, or pain after prior laminectomy. Concerning pain relief, 29/43 patients with spondylolysis-olisthesis were classified as good. The corresponding figures in the group with degenerative disc disease and/or facet joint arthrosis were 8/16 patients and in the group with pain post-laminectomy, 6/12 patients. No surgical complications were noted. In the total material 54 patients had a solid fusion, as defined by radiographic osseous trabecular bridging at all intended levels. One-level fusions tended to heal solidly in a higher frequency than two-level fusions. For the spondylolysis-olisthesis group, healed fusion correlated with a good clinical result. Such a correlation could not be verified for the other diagnostic groups. We conclude that non-instrumented posterolateral lumbar fusion is a valid method for treating low-grade spondylolysis-olisthesis, especially when the aim is to fuse a single level. Improved patient selection methods are required in fusion for degenerative disc disease and pain after laminectomy.
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PMID:Posterolateral lumbar fusion. Outcome of 71 consecutive operations after 4 (2-7) years. 804 84

The incidence of spondylolysis is approximately 5-6% in the white population. Males and females are equally affected. In about one third of the cases spondylolysis is associated with spondylolisthesis. For the etiology mechanical and genetic factors are important. At the L4 level mechanical factors play the dominant role, while at the L5 level genetic factors are equally important (size and orientation of the facet joints, dysplasia of the vertebral arch). Increased risk for low back pain is found in the presence of the following factors: spondylolisthesis exceeding 10 mm, a low lumbar index, increased lumbar lordosis, spondylolysis at the L4 level and early beginning of symptoms. In the absence of one of these factors the risk for low back pain in adulthood is not greater than in the normal population. This statement is supported by the fact that in a low back clinic with more than 2000 patients with low back pain, the incidence of patients with spondylolysis was not higher than in the normal population. In our own study we followed up 31 patients. The majority of them were symptomatic during adolescence. After a follow-up time of 28 years on average 20 of them stated that they had no pain since adolescence, 8 had only occasional pain and only 2 had undergone operative treatment because of significant low back pain.
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PMID:[Natural course in spondylolysis and spondylolisthesis]. 804 54

Between 1986 and 1990 direct repair of the defect in lumbar spondylolysis was performed in 11 patients. The mean age was 20 (14-36). Conservative treatment for at least six months was first tried in all patients. Criteria for operation were absence of degenerative disc lesions on X-rays, maximum spondylolisthesis of 15%, no neurological signs and effect of brace treatment. The Edinburgh technique of tension wiring was used in 11 patients. Mean observation time was three years (one to six). The pain decreased considerably or vanished in nine patients. One improved a little and one was unchanged. None were reoperated. At follow up all 11 patients were working. It is concluded that direct repair of lumbar spondylolysis is a good alternative to intersegmental fusion, when the criteria are kept in mind.
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PMID:[Lumbar spondylolysis treated with cerclage using the method of the 80's]. 805 72

Ten patients suffering from persisting low-back pain underwent direct repair of spondylolysis L5 with hook screws. At a follow-up three to four years after the operation, four patients showed good and six unsatisfactory results. Four patients had a secondary procedure. Average age was relatively high in the study group compared with the literature, and pain tended to be chronic. In five of the six patients with a poor clinical result, radiological consolidation of the lytic defect could not be demonstrated. We are discussing indications based on a literature review.
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PMID:[Direct screwing in spondylolysis: results and observations on indications]. 819 Nov 95

Spinal fixation devices are used in the thoracic and lumbosacral spine to stabilize the spine, reduce deformities and fractures, and replace abnormal vertebrae. A bone fusion is usually attempted along with placement of the instrumentation because in most cases the hardware would eventually fail if it were used alone. The thoracolumbar spine is inherently unstable, and early operative intervention improves mobilization and rehabilitation. In some cases of lumbar spinal pain, surgical intervention is necessary for the treatment of conditions such as herniated disks, spondylolysis with spondylolisthesis, and degenerative disease with scoliosis. Surgical procedures consist of posterior (posterior elements) and anterior (vertebral body) fixation. Radiologists face continual changes in both surgical technique and instrumentation and should be knowledgeable about the devices available and the biomechanical principles that direct their use. They need to work with their surgical colleagues to become familiar with the techniques used at their institutions.
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PMID:Spinal fixation. Part 2. Fixation techniques and hardware for the thoracic and lumbosacral spine. 831 61

Radiography and CT and MRI scans of the lumbar spine were performed in young patients complaining of pain during extension of the lumbar spine but without neurological signs in the lower limbs. T1-weighted MR images in the coronal plane showed a hypo-intense area in the pars interarticularis before the detection of spondylolysis at that site by plain radiography or CT. We suggest that this may be useful in the early diagnosis of spondylolysis.
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PMID:Early diagnosis of lumbar spondylolysis by MRI. 837 35


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