Professional Essays: ANTERIOR spondylolisthesis l4 …
Such indicators point to spondylolisthesis anterior l4 every involves sacrifice
I have a grade 1 spondylolisthesis l4/l5/s1 with stenosis.
Figure 8 is a sagittal radiograph of a 62 year old female with a grade I degenerative spondylolisthesis at L4. Note the anterior translation (slip) of L4 on L5 and the intact pars interarticularis and posterior arch (short red arrows). (*if you're confused, please visit the forthcoming link to learn about .) Therefore, you can tell this is a degenerative spondylolisthesis because there is no fracture line through the pars or posterior arch, as would be expected in an isthmic spondylolisthesis (). Furthermore, the slip is in an elderly female at L4 and does not exceed 30%; all of these findings point to the diagnosis of degenerative spondylolisthesis.
On the Image Left, you can clearly see that L4 has slipped about 25% on L5 (i.e., a grade 1 spondylolisthesis), but can you see the cause of the slip? If you can't, .
Grade 1 anterolisthesis of l4 on l5 - Doctor answers
Fun Facts: Unlike degenerative spondylolisthesis which is commonly seen at L4, isthmic spondylolisthesis typically affects the L5 vertebra.
The figure left is a sagittal (from the side) computed tomographic (CT) image of the 22-year-old female who presented with severe chronic low back pain. The image reveals clear evidence of a non-displaced fracture (a fracture that has not separated very far apart) through both the pars interarticulari (plural) of L4 and L5 (yellow arrows); such findings lend support to the diagnosis of a bi-level spondylolysis. There might be a very slight anterior translation ("slip") of L5 on S1 (maybe 5%), in which case you could call this a spondylolisthesis.
Grade 1 anterior spondylolisthesis of l4 on l5
Although not universally accepted, it is believed by some that a degenerative spondylolisthesis occurs because of an anomalous formation of the lumbar-sacral joint. Specifically, there is either not enough lordosis between L5 and the sacrum, or L5 is sacralized.  Such anatomy may result in a biomechanical overload of the L4 disc and facet joints, which in turn leads to significant degenerative changes of the facet joints and subsequent slip. 
Spondylolisthesis is one of the most common indications for spinal surgery. However, no one approach has been proven to be more effective in treating spondylolisthesis. Recent advances in minimally invasive spine technology have allowed for different approaches to be applied to this indication, notably extreme lateral interbody fusion (XLIF). The risk, however, of using XLIF in treating grade II spondylolisthesis is the ventral position of the lumbar plexus, particularly at L4-5. Objective. This study reports the safety and midterm clinical and radiographic outcomes of patients with grade II lumbar spondylolisthesis treated with XLIF. Methods. 63 patients with grade II spondylolisthesis and spinal stenosis were treated with XLIF and were available for 12-month followup. Of those, 61 (97%) were treated at L4-5. Clinical (VAS, complications, and reoperation rate) and radiographic (anterolisthesis, disk height, and fusion) parameters were assessed. Study Design. Data were collected via a prospective registry and analyzed retrospectively. Results. Sixty-three patients were available for evaluations at least one year postoperatively. Average pain (visual analog scale) decreased from a score of 8.7 at baseline to 2.2 at 12 months postoperatively. Average anterior slippage was reduced by 73% and was well maintained. Average disk height (4.6mm pre-op and 9.0mm post-op) nearly doubled after surgery. Slight settling (average 1.3mm) occurred over the twelve-month follow-up period. There were no neural injuries and no nonunions noted. Conclusions. XLIF is a safe and effective minimally invasive treatment alternative for grade II spondylolisthesis. Real-time neurological monitoring and attention to technique are mandatory.
Degenerative Spondylolisthesis - Spine - Orthobullets
Spondylolysis and Spondylolisthesis of the Lumbar …
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Spondylolysis and spondylolisthesis are the most common causes of structural back pain in children and adolescents.
Minimally Invasive Spinal Fusion Surgery - L4-5 & L5 …
Texas Spine & Neurosurgery Center offers minimally invasive lumbar fusion surgery in Houston, Texas
Spondylolysis and spondylolisthesis : Mr James Langdon
To evaluate the sagittal diameter of the spinal canal, a ratio of the AP diameter at the L5 level to the AP diameter at the L1 level is used. The canal is measured from the posterior cortex of the vertebral body to the anterior aspect of the lamina on a mid-sagittal image. A ratio of 1.25 is normal. This ratio is increased in patients with spondylolysis due to posterior subluxation of the posterior elements, even in cases where no spondylolisthesis is present. Usually, the posterior subluxation of the posterior elements is evident on the mid-sagittal image with a resultant increase in the canal size at the level of the pars defect and actual calculation of a ratio is unnecessary (6a).
The pars interarticularis is a part of a lamina
(9a) T1- and (9b) T2-weighted sagittal images in a patient with spondylolisthesis reveal clear pars defects (arrows). A horizontal configuration of the L5 neural foramina is readily apparent (red outline), with resultant foraminal stenosis. Compare this configuration with the normal keyhole appearance of the L4-5 foramina (blue outline). This horizontal configuration is typical in patients with spondylolisthesis due to spondylolysis.
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