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Treatment of spondylolisthesis
Medical expert of the article
Last reviewed: 20.11.2021
Conservative treatment of spondylolisthesis is indicated in patients with grade 1 and 2 spondylolisthesis in the absence of a neurological deficit. Exclude the axial load on the spine. Prescribe NSAIDs (naproxen, diclofenac, ibuprofen), vitamins B, physiotherapy, exercise therapy, aimed at strengthening the long back muscles and anterior abdominal wall. When doing any physical work, we recommend wearing a semi-rigid corset. Indications for surgical treatment of spondylolisthesis:
- neurologic disorders of compression genesis on the background of stenosis of the spinal canal or chronic trauma of the spine:
- lumbulgia due to instability of the vertebral-motor segment;
- spondyloptosis;
- progressive displacement of the vertebra;
- inefficiency of conservative treatment for 6 months.
The tasks of surgical treatment of spondylolisthesis are divided into two groups.
- The first group is orthopedic:
- Reduction of the L5 body, vertebra and stabilization of the lumbosacral segment of the spine in the achieved position;
- restoration of sagittal and frontal profiles of the lumbosacral spine.
- The second group is neurosurgical:
- relief of pain syndrome;
- elimination of vertebro-spinal conflict;
- restoration of the anatomy of the spinal canal.
- Operative intervention of the modern level includes:
- removal of the arch of the displaced vertebra;
- transpedicular fixation and reduction of the body of the displaced vertebra;
- audit of the spinal canal and radiculolysis;
- Discectomy and interbody corporeodesis autotyped at the pathological level;
- posterior local spondylodesis of autostyles.