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Abstract
Spondylolisthesis is defined as the anterior slippage of one vertebra on another. Spondylolisthesis is a common painful condition but can also be an incidental radiographic finding in asymptomatic persons. Mild spondylolisthesis predisposes to chronic low back pain. The purpose of surgical treatment are to reduce low back pain and radiating pain, to relieve the neurologic symptoms, and to improve the posture by eliminating the instability of the lumbosacral region. The operative procedures include anterior interbody fusion, posterior fusion, posterolateral fusion, Gill's procedure, and repair of the pars interarticularis. The biomechanics of anterior interbody fusion are based on the restoration of the intervertebral disc space and fusion on the intantaneous axis of ratation of the functional vetebral unit. The advantages of anterior interbody fusion are indirect decompression of the spinal canal, decreased posterior muscle injury, reduced bleeding from the operative site, early postoperative ambulation; reduced hospital days, and high fusion rate.
REFERENCES
1). Bergmark A. Stability of the lumbar spine. A study of mechanical engineering. Acta Orthop Scand. 230(suppl):28. 1989.
2). Boos N, Marchesi D, Zuber K, Aebi M. Treatment of severe spondylolisthesis by reduction and pedicular fixation: A 4-6 year followup study. Spine. 18:1655. 1993.
3). Bradford DS, Boachie-Adjei O. Treatment of severe spondylolisthesis by anterior and posterior reduction and stabilization: A longterm followup study. J Bone Joint Surg. 72-A:1060. 1990.
4). Capener N. Spondylolisthesis. Br J Surg. 19:374–386. 1932.
5). Chapman MW. Chapman's Orthopaedic Surgery. Third Edition, Volume 4. .,. Lippincott Williams & Wilkins;p. 4143–4159. 2001.
6). Evans JH. Biomechanics of Lumbar fusion. Clin Orthop. 193:38. 1985.
7). Farfan HF, Osteria V, Larry C. The mechanical etiology of spondylolysis and spondylolisthesis. Clin Orthop Rel Res. 117:40–55. 1976.
8). Feffer HL, Wiesel SW, Cuckler JM, et al. De generative spondylolisthesis: To fuse or not to fuse. Spine. 10:287–289. 1985.
9). Flynn JC, Hoque MA. Anterior fusion of the lumber spine. J Bone Joint Surg. 61-A:1143–1150. 1979.
10). Fredrickson BE, Baker D, McHolick WJ, et al. The natural history of spondylolysis and spondylolisthesis. J Bone Joint Surg. 66A:699–706. 1984.
11). Freebody D, Bandall R, Taylor RD. Anterior trans-peritoneal lumbar fusion. J Bone Joint Surg. 53:617–627. 1971.
12). Fujimaki A, Crock HV, Bedbrook GM. The results of 150 anterior lumber interbody fusion operations performed by two surgeons in Australia. Clin Orthop. 165:164–167. 1982.
13). Harmon PH. Anterior excision and vertebral body fusion operation for intervertebral disc syndroms of the lumbar spine. Clin Orthop. 26:107–127. 1963.
14). Hodgson AR, Stock FE, Fang HS, Ong GB. Anterior spine fusion: The operative approach and pathological findings in 412 patients with Pott's disease of spine. British J Surg. 48:172. 1960.
15). Inoue SI, Watanabe T, Goto S, et al. Degenerative spondylolisthesis. Pathophysiology and results of anterior interbody fusion. Clin Orthop Rel Res. 227:90–98. 1988.
16). Ito H, Tsuchiya J, Asami G. A new radical operation for Pott's disease: Report of ten cases. J Bone Joint Surg. 16:499–515. 1934.
17). Kang JS, Kim NH. The result of anterior interbody fusion on low back problem. J of Korean Orthp Assoc. 21(1):47–56. 1986.
18). Kim NH, Lee WH. Clinical study on treatment of spndylolisthesis. J of Korean Orthp Assoc. 27(5):1263–1272. 1992.
19). Kim NH, Shin JS, CHung SM, Kang MK. Study on ack instability after laminectomy and diskectomy. The J of WPOA. 17:28. 1980.
20). Kirkaldy-Willis WH, Wedge JH, Yong-Hong K, et al. Pathology and pathogenesis of lumbar spondylolysis and stenosis. Spine. 3:319–328. 1978.
21). Kummer B. Funktionelle und pathologische anatomie der Lenden-irbelsaule. Orthop Praxis. 18:84. 1982.
22). Muschik M, Zippel H, Perka C. Surgical management of severe spondylolisthesis in children and adolescents: Anterior fusion in situ versus anterior spondylodesis with posterior transpedicular instrumentation and reduction. Spine. 22:2036. 1997.
23). Paajanen H, Tertti M. Association of incipient disc degeneration and instability in spondylolisthesis. A magnetic resonance and flexion-extension radiographic study of 20-year-old low back pain patients. Orthop Trauma Surg. 111:16–19. 1991.
24). Putz R. The functional morphology of the superior articular process of the lumbar vertebra. J Anat. 143:181. 1985.
25). Rolander SD. Motion of the lumbar spine with special reference to the stabilizing effect of posterior fusion An experimental study on autopsy specimensis. Acta Orthop Scand. 90(suppl):83. 1966.
26). Sacks S. Anterior interbody fusion of the lumbar spine. Clin Orthop. 44:163. 1966.
27). Sevastikoglou JA, Spangfort E, Aaro S. Operative treatment of spondylolisthesis in children and adolescents with tight hamstring syndrome. Clin Orthop. 147:192–199. 1980.
28). Szypryt EP, Twining P, Mulholland RC, et al. The prevalence of disc degeneration associated with neural arch defects of the lumbar spine assessed by magnetic resonance imaging. Spine. 14:977–981. 1989.
29). Wiltse LL, Newman PH, Macnab I. Classification of spondylolysis and spondylolisthesis. Clin Orthop. 117:23–29. 1976.
30). Wiltse LL, Rothman SG. Lumbar and lumbosacral spondylolisthesis: Classification, diagnosis, and natural history. in Wiesel SW, Weinstein JN, et al(eds): The lumbar spine (2nd ed).Philadelpha, PA: W.B. Saunders Company;1996.
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