Sunday, May 29, 2011

Spondylolisthesis - Signs and symptoms

Acute isthmic spondylolisthesis occurs in the first or second decade of life. Most cases occur before the patient reaches 15 years. In rare cases the disease can be observed in adulthood.Younger patients are at increased risk of developing progressive spondylolisthesis against the elderly. risk of progression for adults is small if the condition is located at L5. At L4-5 lesions may progress in adulthood due to increased sagittal and axial rotation at this segment. Dysplasia spondylolisthesis occur in children age 3-5 months or ambulatiei. Degenerative spondylolisthesis occurs most commonly in the age of 40 years.
Isthmic spondylolisthesis:Symptoms appear in adolescence. It reported back pain during activities. The pain radiates to the buttocks and thighs. It may be more significant with higher degrees of mechanical characteristics in spondylolisthesis. In most cases patients do not blame symptoms that suggest neurologic disease in small degrees.Radicular pain is common in large landslides. Pain radiating below the knee associated with paresthesia in the distribution of a dermatome suggests radiculopathy foramen stenosis or herniated disc simultaneously.
Incarceration nerve roots fibrocartilaginoase structures can be described.Higher degrees of damage can cause neurogenic caludicatie or symptoms suggesting ponytail syndrome. Patient pain is caused by back extension activity. Patients with acute spondylolisthesis tend to produce work that requires a low tolerance to excessive mechanical loading of the spine, sitting position is better tolerated.A large number of patients are asymptomatic. Progression of spondylolisthesis may develop without symptoms.
Note the lumbar spasm. The inequality is detected vertebral palpation. Lumbosacral kyphosis is seen in severely affected by the degree thoracolombar compensatory lordosis. Shortening of the trunk may be present. In severe landslides thoracic cage can support an iliac crest. Numbness meet this dermatome is involved and if radiculopathy or stenosis. Note waddle.
Degenerative spondylolisthesis:The pain begins insidiously and has the character of cramp. It is located posterior lumbar and groin. Neurogenic claudication may also be present with symptoms of lower limb aggravated by activity and relieved by rest. Symptoms are chronic and progressive, although patients may experience periods of remission.
Dysplasia spondylolisthesis: isthmic symptoms are similar shape but is most common neurological impairment.Traumatic spondylolisthesis: patients have acute pain associated with trauma. If slippage is severe ponytail syndrome occurs with classical symptoms of sphincter dysfunction, neurological claudication and radicular symptoms.Pathological Spondilolistoza: insidious and symptoms are associated with radicular pain / claudication.
Disease progression:Increased mortality is associated with spondylolisthesis. While some patients may experience mild back pain, significant disability is rare if the patient has no neurological deficit and severe. Morbidity is represented by persistent back pain or nerve incarceration. Since disc degeneration is accelerated in the spondylolisthesis may occur discogenica pain. Arthritic degenerative spondylolisthesis produces characteristic symptoms worsen with age.The most common complication of spondylolisthesis of any type is incarceration nerve / radiculopathy in the disease. Spinal stenosis and ponytail syndrome can occur if the slip is significant.

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