Spondylolisthesis

Spondylolisthesis

Spondylolysis defines a defect in the pars interarticularis of the vertebra. There are six types including congenital and trau matic. Spondylolisthesis occurs when the upper vertebra slips forward on the lower; it is graded according to the percentage slip , measured by relating the slipped vertebra to the one below ( Table 44.13 ). Mild slips are often asymptomatic and require no treat ment. Treatment (physiotherapy , bracing and surgery) depends on the degree of slip and symptoms; mechanical back pain may respond to conservative methods, but neurological involvement usually requires sur gical intervention. In torticollis the head is tilted towards and rotated away from the tight sternocleidomastoid muscle. Congenital torticollis is usually secondary to intrauterine moulding but may present with a fixed sternocleidomastoid contracture or a palpable ‘tumour’ within the muscle. Most cases resolve with stretching but persistent cases develop facial asymmetr y requiring release of the origin and/or insertion of the sternocleidomastoid muscle. Acquired torticollis is rare and may be caused by inflam - mation/infection, ocular problems, atlantoaxial rotatory sub - luxation or a posterior fossa tumour.

TABLE 44.13 Classi /f_i cation of spondylolisthesis according to severity of the slip. Grade Percentage slip 0 No slip 1 <25 2 26–50 3 51–75 4

75 Spondyloptosis 100 – complete translation

Spondylolisthesis

Spondylolysis defines a defect in the pars interarticularis of the vertebra. There are six types including congenital and trau matic. Spondylolisthesis occurs when the upper vertebra slips forward on the lower; it is graded according to the percentage slip , measured by relating the slipped vertebra to the one below ( Table 44.13 ). Mild slips are often asymptomatic and require no treat ment. Treatment (physiotherapy , bracing and surgery) depends on the degree of slip and symptoms; mechanical back pain may respond to conservative methods, but neurological involvement usually requires sur gical intervention. In torticollis the head is tilted towards and rotated away from the tight sternocleidomastoid muscle. Congenital torticollis is usually secondary to intrauterine moulding but may present with a fixed sternocleidomastoid contracture or a palpable ‘tumour’ within the muscle. Most cases resolve with stretching but persistent cases develop facial asymmetr y requiring release of the origin and/or insertion of the sternocleidomastoid muscle. Acquired torticollis is rare and may be caused by inflam - mation/infection, ocular problems, atlantoaxial rotatory sub - luxation or a posterior fossa tumour.

TABLE 44.13 Classi /f_i cation of spondylolisthesis according to severity of the slip. Grade Percentage slip 0 No slip 1 <25 2 26–50 3 51–75 4

75 Spondyloptosis 100 – complete translation

Spondylolisthesis

Spondylolysis defines a defect in the pars interarticularis of the vertebra. There are six types including congenital and trau matic. Spondylolisthesis occurs when the upper vertebra slips forward on the lower; it is graded according to the percentage slip , measured by relating the slipped vertebra to the one below ( Table 44.13 ). Mild slips are often asymptomatic and require no treat ment. Treatment (physiotherapy , bracing and surgery) depends on the degree of slip and symptoms; mechanical back pain may respond to conservative methods, but neurological involvement usually requires sur gical intervention. In torticollis the head is tilted towards and rotated away from the tight sternocleidomastoid muscle. Congenital torticollis is usually secondary to intrauterine moulding but may present with a fixed sternocleidomastoid contracture or a palpable ‘tumour’ within the muscle. Most cases resolve with stretching but persistent cases develop facial asymmetr y requiring release of the origin and/or insertion of the sternocleidomastoid muscle. Acquired torticollis is rare and may be caused by inflam - mation/infection, ocular problems, atlantoaxial rotatory sub - luxation or a posterior fossa tumour.

TABLE 44.13 Classi /f_i cation of spondylolisthesis according to severity of the slip. Grade Percentage slip 0 No slip 1 <25 2 26–50 3 51–75 4

75 Spondyloptosis 100 – complete translation