Summary
Forty-five patients with spondylolisthesis have been reviewed, all operated with the same surgical procedure: dorso-lateral bilateral fusion. A comparative study was made between two age groups-adolescents (n=22) and adults ((n=23).
Preoperative symptoms, clinical signs and X-rays of the patients were analysed and compared with postoperative results. The symptoms observed preoperatively differ between these two age groups. In the adolescents, low back pain dominated, whereas sciatic pain did so in the adults.
Scoliosis and spina bifida were only found in the younger group, but disc degeneration was, as expected, more often found in the older group. The postoperative results were improved considerably in the younger group and it is suggested that the main cause of the preoperative symptoms in these patients was instability. In the adults, on the other hand, the symptoms seemed to be less due to this instability but rather to other factors, such as disc degeneration and nerve root compression.
Zusammenfassung
Fünfundvierzig Patienten, die wegen einer Spondylolisthesis alle nach dem gleichen Verfahren operiert worden sind, wurden nachuntersucht: bei allen wurde eine beidseitige dorsolaterale Fusion durchgeführt. Es wurden vergleichende Untersuchungen zwischen zwei Altersgruppen durchgeführt: Jugendliche (n=22) und Erwachsene (n=23).
Präoperative Symptome, klinische Befunde und Röntgenbilder der Patienten wurden analysiert und mit den postoperativen Ergebnissen verglichen. Die präoperativen Symptome unterscheiden sich zwischen den beiden Altersgruppen: Bei den Jugendlichen dominierten die Kreuzschmerzen, bei den Erwachsenen die radikuläre Irritation.
Skoliose und Spina bifida wurden nur bei den Jugendlichen angetroffen, Bandscheibendegenerationen waren erwartungsgemäß bei den Erwachsenen häufiger.
Die Jugendlichen zeigten eine wesentliche Besserung nach der Operation und es wird geschlossen, daß der Hauptgrund für die präoperativen Symptome bei diesen Patienten in einer Instabilität zu erblicken ist. Bei den Erwachsenen hingegen stehen Bandscheibenschālden und Nervenwurzelkompressionen im Vordergrund.
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Financial support was obtained from the Swedish Medical Research Council, project No. B82-17X-04780-07.
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Haraldsson, S., Willner, S. A comparative study of spondylolisthesis in operations on adolescents and adults. Arch. Orth. Traum. Surg. 101, 101–105 (1983). https://doi.org/10.1007/BF00433269
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DOI: https://doi.org/10.1007/BF00433269