|
|
Inomed ISIS
IOM
Starting from
August 2007, we are performing all pedicle
screw surgeries with the use of Inomed
special instrumentation for pedicular screw
monitoring. |
|
|
|
|
Add Your Text!
You can easily modify
this page by selecting the text and replacing
it with your own content. |
|
|
|
|
|
|
|
|
|
|
|
Conservative Treatment
Most
patients without neurological symptoms or signs
should initially be managed conservatively. However,
studies have shown that up to one-third of patients
with isthmic or degenerative spondylolisthesis are
at risk for progressive listhesis, which may lead to
neurological deficiencies. Unfortunately, this
high-risk population has been difficult to define.
Factors reported to be associated with progressive
slippage include skeletal immaturity, female sex,
dysplasia of the posterior elements, spina bifida
occulta, increased slip at diagnosis, a high
sagittal rotation angle, and rounding of the
superior aspect of the sacrum. Individually, though,
none of these factors has been shown to have a
consistent effect on slip progression. Still,
patients with a combination of these risk factors
should be considered for early surgery.
Both flexion exercises and braces designed to reduce
lumbar lordosis have demonstrated some efficacy in
symptomatic patients with Meyerding grade I or II
spondylolisthesis. Other nonoperative techniques
such as bedrest, restriction of sports activities,
anti-inflammatory analgesics, or injection of the
disc space or facet joints with steroids or topical
anaesthetics may be of diagnostic assistance, but
are of uncertain long-term therapeutic benefit
|
|
|
|
|
|