surgical instrumental treatments for Lumbar spondylolisthesis
Fájlok
Dátum
Szerzők
Folyóirat címe
Folyóirat ISSN
Kötet címe (évfolyam száma)
Kiadó
Absztrakt
Degenerative changes in the intervertebral disc and facet joints cause one or more spinal segments to become unstable over time. This is called lumbar degenerative spondylolisthesis. Since the facet joints move laterally, the spinal body slides forward. This is what the condition is known for. It was called type III by Wiltse, Newman, and Macnab. This is a common problem in older people, and women are five times more likely than men to have it. The most common area affected is L4–L5, and the listhesis rarely goes beyond 30% slip. It might or might not cause clinical symptoms, and the intensity of these symptoms isn't always related to the amount of sliding. Lumbar pain, with or without radicular pain, is the main sign. Seventy-five percent of people who have neurogenic symptoms experience pain in their lower limbs when they walk short distances. This is because the nerve roots are compressed, preventing enough blood flow. The first line to diagnose if someone has degenerative spondylolisthesis, is to get a full physical exam that includes static and dynamic x-rays while they are standing and magnetic resonance imaging. The first line of treatment is preventive care, which includes painkillers, anti-inflammatories, and physical therapy. There are a number of methods and surgical techniques that can be used to decompress the nerve root, limit mobility, and fuse the listhesis. One method is posterior interbody fusion, which includes direct and indirect root decompression with the fusion of the vertebral bodies and the placement of an autologous bone graft between the transverse apophysis and the vertebral bodies. In the same way that transforaminal lumbar and posterior interbody fusion try to decompress and join the spine, they do so in different ways. The anterior method to interbody fusion works better for fusing the bones together. With an anterolateral transpsoas method, lateral lumbar interbody fusion is thought to be less invasive. In cases of degenerative spondylolisthesis, the lumbar fusion method needs to be tailored to each patient. Non-fusion decompression is thought to be less invasive. Several studies show that adding fusion to decompression makes the effects better. Surgery might have a number of benefits, and it works better for people who don't improve with conservative treatment. It is not clear that there is a single best method. Degenerative disc and facet joint disease of the lumbar spine affects a lot of older people and is one of the main reasons why people can't complete their daily tasks. If you have lumbar spondylosis, you might have back pain, radicular and claudicant symptoms, less movement, and a lower quality of life. When degenerative levels are fused together surgically, the painful moving section can be stabilized. This procedure may also help relieve pressure on the 8 nerves, restore lordosis, and fix deformity. Posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion (TLIF), minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) are some of the surgeries that can be used to fuse the lumbar spine. Others are oblique lumbar interbody fusion/anterior to psoas (OLIF/ATP), lateral lumbar interbody fusion (LLIF), and anterior lumbar interbody fusion (ALIF). Discogenic or facetogenic low back pain, neurogenic claudication, radiculopathy due to foraminal stenosis, and lumbar degenerative spine deformity such as symptomatic spondylolisthesis and degenerative scoliosis are some of the conditions that may be treated. Because they have high fusion rates and low complication rates, traditional posterior techniques are frequently utilized in surgical procedures. The sac and nerve root retraction, as well as damage to the paraspinal muscles and the disruption of the posterior tension band, are some of the factors that restrict their ability to perform the maneuver. In order to cut down on problems related to approaches, minimally invasive (MIS) posterior approaches have grown in popularity. Anterior methods stay away from the spinal canal, the cauda equina, and the nerve roots. However, can cause problems with the abdomen and blood vessels. Also, the lumbar plexus and psoas muscle could be hurt by lateral and OLIF methods. The first goal of this study is to look at all the literature and data that is already out there on different lumbar interbody fusion (LIF) techniques.