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KMID : 0378019870300010055
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New Medical Journal
1987 Volume.30 No. 1 p.55 ~ p.60
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Surgical management of degenerative lumbar spondylolisthesis with an intact neural arch
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Abstract
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We have operated 64 cases of degenerative spondylolisthesis with an intact neural arch from 1976 :o March, 1986.
The results were summarized_ as followings.
1. The most common age group was 50´s (about 50%). The 40´s and 50´s were common in females and the 50´s and 60´s in males, . 2. Male to female ratio was I to 4.
3. The most common level of slipping was L,-s(80%) and the next were L,-,(9.4%) and LS S1(3.1%). The average degree of slipping was about 7mm (range 5-10mm).
4. The pedicle-facet angle at the level of slipping was commonly increased above 100°. The range of the abnormal angles was 95°-145°.
5. We have considered that the primary etiological factor is a congenitally increased pedicle-facet angle. In addition to this factor, if degenerative arthritis of the spines develops severely at the older age, then further slipping could develop.
6. The most characteristic symptom of the disease is neurogenic intermittent claudication.
7. Clinically, it is important to use our flow chart in the management of the disease (Fig. 2).
8. If the conservative management is failed to improve, then surgical treatment should be considered.
Wide decompressive laminectomies, medial facetectomies, and foraminotomies to decompress the dural
sac and nerve roots result in the best prognosis.
9. We must consider case by case a patient´s age, condition,various X-rays and CT findings and operative findings before we decide how wide laminectomies, whether to remove disc, or whether to fuse or not.
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