Podcast
Questions and Answers
What is spondylolysis defined as?
What is spondylolysis defined as?
- A condition in which there is a defect in the facet joint of a lumbar vertebra
- A condition in which there is a defect in the pedicle of a lumbar vertebra
- A condition in which there is a defect in the pars-interarticularis of a lumbar vertebra (correct)
- A condition in which there is a defect in the lumbar vertebra
What is the most common direction of the slip in spondylolisthesis?
What is the most common direction of the slip in spondylolisthesis?
- Lateral
- Medial
- Forward (correct)
- Backward
What is the common site for spondylolisthesis?
What is the common site for spondylolisthesis?
- T12/L1
- C5/C6
- L4/L5 and L5/S1 (correct)
- L3/L4
What is the structure that locks over the superior facet of the vertebra below?
What is the structure that locks over the superior facet of the vertebra below?
What is the consequence when the pars interarticularis 'gives'?
What is the consequence when the pars interarticularis 'gives'?
What is a type of spondylolisthesis that occurs due to congenital underdevelopment of the superior articular facets?
What is a type of spondylolisthesis that occurs due to congenital underdevelopment of the superior articular facets?
What is a common symptom of spondylolisthesis?
What is a common symptom of spondylolisthesis?
What is a sign of spondylolisthesis?
What is a sign of spondylolisthesis?
What was the Experimental group treated with?
What was the Experimental group treated with?
What was the goal of the exercise program for the Experimental group?
What was the goal of the exercise program for the Experimental group?
What was the result of the treatment for the Experimental group?
What was the result of the treatment for the Experimental group?
What exercise was NOT part of the Experimental group's treatment?
What exercise was NOT part of the Experimental group's treatment?
What was the focus of the postural awareness instruction for the Experimental group?
What was the focus of the postural awareness instruction for the Experimental group?
What type of instruction was given to the Experimental group regarding activities?
What type of instruction was given to the Experimental group regarding activities?
What was the focus of the exercise program for the Experimental group?
What was the focus of the exercise program for the Experimental group?
What was part of the home exercise program for the Experimental group?
What was part of the home exercise program for the Experimental group?
What is a characteristic gait pattern observed in individuals with this condition?
What is a characteristic gait pattern observed in individuals with this condition?
What is the primary reason for using a lumbo-sacral support in non-operative treatment?
What is the primary reason for using a lumbo-sacral support in non-operative treatment?
What is the primary goal of operative intervention in this condition?
What is the primary goal of operative intervention in this condition?
What is the effect of sitting on pain in this condition?
What is the effect of sitting on pain in this condition?
What is the primary purpose of advising on posture, back care, and lifting in non-operative treatment?
What is the primary purpose of advising on posture, back care, and lifting in non-operative treatment?
What is the effect of prolonged standing and activity on pain in this condition?
What is the effect of prolonged standing and activity on pain in this condition?
What is the effect of lying on pain in this condition?
What is the effect of lying on pain in this condition?
What is the primary role of mobilizations and soft-tissue techniques in non-operative treatment?
What is the primary role of mobilizations and soft-tissue techniques in non-operative treatment?
Study Notes
Spondylolysis
- A condition characterized by a defect in the pars-interarticularis of a lumbar vertebra
- Believed to be a stress fracture or congenital abnormality, resulting in fibrous tissue replacing the narrow part of the pars interarticularis
Spondylolisthesis
- A condition where the body of a vertebra slips on the one below, usually forwards, but occasionally backwards
- Common sites are L5/S1 and L4/L5
- Stability of the L4/5/S1 part of the lumbar spine depends on the pedicle, pars interarticularis, and inferior articular facet locking over the superior facet of the vertebra below
Types of Spondylolisthesis
- Traumatic
- Isthmic (resulting from spondylolysis)
- Congenital
- Degenerative
- Pathological
Causes of Spondylolisthesis
- Spondylolysis leading to separation of the pars interarticularis
- Degenerative changes leading to subluxation of the facet joints
- Congenital underdevelopment of the superior articular facets
- Fracture due to trauma
- Pathological weakening of bone (e.g., malignant or osteoporosis)
Signs and Symptoms
- Low back pain and neurogenic leg symptoms
- Pain commonly localized to the paraspinal region, gluteal, and posterior aspect of the thighs
- Restricted lumbar range of motion, paraspinal muscle spasm, and posterior tilting of the pelvis
- Characteristic pelvic 'waddle' may be observed
- Pain relieved on lying and aggravated by prolonged standing and activity
- Pain reproduced with the one-legged standing lumbar extension test
Treatment
- Non-operative treatment:
- Pain relief with warmth and heating
- Lumbo-sacral support to relieve pain
- Active exercises to strengthen abdominal and back extensor muscles
- Advice on posture, back care, and lifting
- Loss of weight if necessary
- Mobilizations and soft-tissue techniques to restore movement to levels of the lumbar spine above the level of the lesion
- Operative treatment:
- Decompression of nerve roots and spinal fusion of affected segments
- Indicated for severe symptoms
Experimental Treatment
- Passive stretching of bilateral hip flexors, hamstrings, piriformis, and Williams flexion exercises
- Myofascial release, posterior pelvic tilt exercise, central PA mobilization of the thoracic spine
- Significant reduction in vertebral slip percentage from pre-treatment to post-treatment measurement
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Description
Learn about Spondylolysis, a condition causing defects in lumbar vertebrae, and Spondylolisthesis, a condition where a vertebra slips out of place.
