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Pipsa Ylanko, AOSpine Global Education Manager

General Editor: Luiz Vialle

Authors: Jean Ouellet

Spondylolisthesis Type 4

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Glossary

1 Introduction top

Indications

Asymptomatic patients should be observed and are not surgical candidates unless:

  • Progressive listhesis
  • High grade spondylolisthesis

Activity modification

Activity modification is recommended during painful episodes.

2 Physical therapy top

A course of physical therapy focussing on core muscle strengthening (erector spinae muscle, psoas, and rectus abdominis) is the key to conservative treatment.

3 Pain management top

Adjuvant medical treatment consisting of anti inflammatories, muscle relaxants may alleviate acute exacerbation of pain.

For children orthotic can also alleviate pain. A course of 6-12 weeks of a TLSO with thigh extension has been shown to be effective in pain relief.


enlarge

A pars block consisting of local anesthetic (marcain) and steroids injection into / around the pars articularis has been shown to decrease pain. This can also be a diagnostic procedure confirming patients actual low back pain originates from the spondylolisthesis/spondylolysis.

v1.0 2016-12-01