Journal List > J Korean Soc Spine Surg > v.8(1) > 1035996

Shin, Kim, Yun, Lee, Kim, and Kim: Lumbar HIVD Associated with Spondylolysis

Abstract

Study Design

This is a retrospective study determining the surgical result of lumbar HIVD associated with spondylolysis.

Objectives

To analyze the incidence of lumbar HIVD associated with spondylolysis and to compare the results of open discectomy for lumbar HIVD associated with spondylolysis to simple lumbar HIVD.

Summary of Literature Review

Lumbar HIVD associated with spondylolysis need be treated by spinal fusion.

Materials and Methods

Nine patients(5 males and 4 females) who had lumbar HIVD with spondylolysis, no instability, follow-up period of 1yr were identified out of 273 patients with lumbar HIVD, treated by open discectomy from March 1989 to Feb. 1999. The type of HIVD and level of spondylolysis were evaluated, the clinical symptoms and signs including SLR, motor deficit, sensory deficit, change of DTR and severity of radiating pain were periodically followed up on the predesigned protocol.

Results

The incidence of lumbar HIVD associated with spondylolysis is 3.7%. The recovery of back pain was 2.1 to 2.1by visu-al analogue scale, radiating pain was 7.6 to 0.8. The recovery rate of SLR was 100%, motor deficit; 100%, sensory deficit; 85%, change of DTR; 40%. The clinical evaluation was excellent(2), good(6), fair(1).

Conclusions

A ccording to the recovery rate of the clinical symptoms, the results of open discectomy for lumbar HIVD associated with spondylolysis without spinal instability and simple HIV D was not different. Therefore, we conclude that lumbar HIVD associated with spondylolysis need not be treated by spinal fusion.

REFERENCES

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Fig. 1-A.
Plane radiographs of 49 year-old man with herniated intervertebral disc at L4-5 and L5-S1 and spondylosis at L5 show well demarcated pars interarticularis defect(arrow head). Fig. 1-B. After open discectomy of both L4-5, L5-S1 level, spondylolisthetic anterior translation of L4 vertebral body was not occurred on the last follow-up radiographs.
jkss-8-74f1.tif
Fig. 2.
CT image shows that spondylolytic defects have irregular contours, sclerosis, and loss of cortical bone continuity (arrow head).
jkss-8-74f2.tif
Fig. 3-A, B.
T2 weighted sagittal and axial MR images show the herniated intervertebral disc at L4-5, L5-S1 level and a low signal intensity area in the left pars interarticularis of L5(arrow head).
jkss-8-74f3.tif
Table 1.
Clinical features of HIVD with spondylolysis
jkss-8-74t1.tif
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