Summary
The isthmic spondylolisthesis, as a result of a spondylolysis, has an incidence of about 5 %. It plays a major role in the cause of low back pain. If conservative treatment fails, surgery is indicated. The study examined the working disability after fusion operations due to isthmic spondylolisthesis. The results are very promising, as 2/3 of the patients could go back to the same work. 87 % of the patients showed a good or very good outcome. This operation should thus be recommended if conservative treatment fails.
Zusammenfassung
Die "isthmische Spondylolisthese", also die Olisthese bei Spondylolyse, hat eine Inzidenz von rund 5 %. Es stellt eine häufige Ursache des Low Back Pain dar. Bei infauster konservativer Therapie stellt die Operation die Behandlung der Wahl dar. Die Fusion kann helfen, die Arbeitsfähigkeit wieder herzustellen. Diese Nachuntersuchung zeigt, dass 2/3 der Patienten nach der Operation wieder die gleiche Arbeit aufnehmen konnten. In 87 % der Fälle konnten gute und sehr gute Ergebnisse nach Fusion der Wirbelsäule bei einer isthmischen Spondylolisthese erreicht werden. Es darf daher nach infauster konservativer Therapie die Operation als Mittel der Wahl vorgeschlagen werden.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Literatur
Wiltse LL, Widell EH, Jackson DW (1975) Fatigue fracture: the basic lesion in isthmic spondylolisthesis. J Bone Joint Surg 57 A: 17–22
Wiltse LL, Jackson DW (1976) Treatment of spondylolisthesis in children. Clin Orthop 117: 92–100
Hopf Ch, Grimm J, Arai Y (1991) Ergebnisse der operativen Behandlung bei Spondylolisthesen sowie bei lumbalen und sakralen Wirbelsäuleneingriffen. Z Orthop 129: 365–373
Suh PB, Esses SI, Kostuik JP (1991) Repair of pars interarticularis defect. The prognostic value of pars infiltration. Spine 16 (Suppl): S445–S448
Fritzell P, Hagg O, Jonsson D, Nordwall A, and the Swedish Lumbar Spine Study Group (2004) Cost-effectiveness of lumbar fusion and nonsurgical treatment for chronic low back pain in the Swedish Lumbar Spine Study: A multicenter, randomized, controlled trial from the Swedish Lumbar Spine Study Group. Spine 29: 421–434
Eggli S, Schläpfer F, Angst M, Witschger P, Aebi M (1992) Biomechanical testing of three newly developed transpedicular multisegmental fixation systems. Eur Spine J 1: 109–116
Magerl F, Angst M, Schläpfer F (1992) Biomechanische Untersuchungen an der Wirbelsäule. Ihre Bedeutung für die Entwicklung rationeller Behandlungstechniken. Orthopäde 21: 24–28
Zindrick MR, Wiltse LL, Widell EH, Thomas JC, Holland WR, Field BT, Spencer CW (1986) A biomechanical study of intrapeduncular screw fixation in the lumbosacral spine. Clin Orthop 203: 99–112
Chen L, Yang H, Tang T (2005) Cage migration in spondylolisthesis treated with posterior lumbar interbody fusion using BAK cages. Spine 30: 2171–2175
Gill GG, Manning JG, White HL (1955) Surgical treatment of spondylolisthesis without spine fusion; excision of the loose lamina with decompression of the nerve roots. J Bone Joint Surg 37-A: 493–519
Hensinger RN (1989) Spondylolysis and spondylolisthesis in children and adolescents; current concepts review. J Bone Joint Surg 71-A: 1098–1107
Spruit M, van Jonbergen JPW, de Kleuver M (2005) A concise follow-up of a previous report: posterior reduction and anterior lumbar interbody fusion in symptomatic low-grade adult isthmic spondylolisthesis. Eur Spine J 14: 828–832
Kornblum MB, Fischgrund JS, Herkowitz HN, Abraham DA, Berkower DL, Ditkoff JS (2004) Degenerative lumbar spondylolisthesis with spinal stenosis: a prospective long-term study comparing fusion and pseudarthrosis. Spine 29: 726–734
McLain RF (2006) Editorial: Instrumented fusion for degenerative spondylolisthesis: is it necessary? Spine 29: 170
Phillips FM (2006) Editorial: The argument for noninstrumented posterolateral fusion for patients with spinal stenosis and degenerative spondylolisthesis. Spine 29: 170–172
Pink TP, Ivanic GM (2004) Die operative Behandlung der Spondyloptose L5/S1. Z Orthop ihre Grenzgeb 142(2): 134–135
Mofidi A, Sedhom M, O'Shea K, Fogarty EE, Dowling F (2005) Is high level of disability an indication for spinal fusion? Analysis of long-term outcome after posterior lumbar interbody fusion using carbon fiber cages. J Spinal Disord Tech 18: 479–484
Ivanic GM, Pink PT, Schneider F, Stücker M, Homann NC, Preidler KW (2006) Prevention of epidural scarring after microdiscectomy: a randomized clinical trial comparing gel and expanded polytetrafluoroethylene membrane. Eur Spine J 15: 1360–1366
Ivanic GM, Wild A, Pink TP, Homann NC (2002) Prevention of epidural fibrosis. Initial experiences with nonabsorbable membrane. Unfallchirurg 105: 483–485
Ivanic GM, Pink TP, Homann NC, Scheitza W, Goyal S (2001) The post-discectomy syndrome. Aetiology, diagnosis, treatment prevention. Arch Orthop Trauma Surg 121: 494–500
Ivanic GM, Harter B, Passl M, Ziegler S (2006) Die semirigide Fixation nach Fusionsoperationen. Jatros Orthopädie 2;or020646
Ivanic GM, Pink TP, Achatz W, Ward JC, Homann NC, May M (2003) Direct stabilization of lumbar spondylolysis with a hook screw: mean 11-year follow-up period for 113 patients. Spine 28: 255–259
Fischgrund JS (2006) Editorial: The argument for instrumented decompressive posterolateral fusion for patients with degenerative spondylolisthesis and spinal stenosis. Spine 29: 173–174
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ivanic, G., Pink, P., Ziegler, S. et al. Mittelfristige Ergebnisse nach Fusionsoperationen bei isthmischer Spondylolisthese und deren Auswirkung auf die Arbeitsfähigkeit. Wien Med Wochenschr 157, 16–20 (2007). https://doi.org/10.1007/s10354-006-0366-6
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/s10354-006-0366-6