Document Detail

Treatment of spondylolysis and spondylolisthesis in children and adolescents.
MedLine Citation:
PMID:  9137179     Owner:  NLM     Status:  MEDLINE    
The treatment of spondylolysis and spondylolisthesis in children depends on the severity of clinical symptoms, pathologic anatomy, and prognosis. Simple spondylolysis can be cured by immobilization alone in selected cases, or by surgery when it remains symptomatic and resistant to nonoperative treatment. The majority of cases are asymptomatic and require no treatment. Spondylolisthesis is classified into 2 types based on the magnitude of the lumbosacral angle: spondylolisthesis with a horizontal sacrum (lumbosacral angle > or = 100 degrees), which seldom requires surgical treatment, usually responds to orthotic management, and generally shows little progression; spondylolisthesis with a vertical sacrum (lumbosacral angle < 100 degrees) which is always progressive, can produce neurologic impairment and cosmetic and functional disability, and requires surgical treatment. In 17 cases the author has reduced the latter deformity by gradual traction in hyperextension followed by cast immobilization, then stabilized the reduction by posterolateral fusion performed through the cast without instrumentation and without opening the spinal canal. When the lumbosacral angle is not improved to 100 degrees or more by hyperextension and traction, an anterior console interbody fusion is added before the posterolateral fusion.
J Dubousset
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  -     ISSN:  0009-921X     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  1997 Apr 
Date Detail:
Created Date:  1997-06-04     Completed Date:  1997-06-04     Revised Date:  2005-03-03    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  77-85     Citation Subset:  AIM; IM    
Hopital St. Vincent de Paul, Universite Rene Descartes, Paris, France.
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MeSH Terms
Casts, Surgical*
Spinal Fusion / methods
Spondylolisthesis / therapy*
Spondylolysis / classification,  therapy*

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