JAAOS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Lauerman, W.
Right arrow Articles by Cain, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Lauerman, W.
Right arrow Articles by Cain, J.

Isthmic Spondylolisthesis in the Adult

WC Lauerman and JE Cain

Department of Orthopaedic Surgery, Georgetown University Medical Center, Washington, DC.

Isthmic spondylolisthesis is a common condition and is frequently identified in the adult patient with low back pain. Although the natural history of this condition is not well defined, it is a common indication for nonoperative and operative treatment. The authors outline a systematic approach to the evaluation of the adult patient with isthmic spondylolisthesis. If radiologic studies are required, magnetic resonance imaging has improved the visualization of nerve-root compression in the neural foramen and is now widely used. Nonoperative treatment is the preferred approach in most symptomatic patients and is successful in as many as 60%. If nonoperative treatment fails, surgery may be recommended. Arthrodesis continues to be the mainstay of surgical treatment. Nerve-root decompression can be used in selected patients with radiculopathy. Although the Food and Drug Administration still considers the use of pedicle-screw instrumentation investigational or experimental, it has gained wide acceptance as an adjunct to fusion in the adult. It is important to note, however, that such use has not yet been proved safe and effective. Reduction of the spondylolisthetic segment has increased in acceptance for a small subset of patients with defined indications but carries a significant risk of complications.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1996 by the American Academy of Orthopaedic Surgeons.