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Trauma

SPONDYLOLYSIS AND SPONDYLOLISTHESIS IN CHILDREN. CONSERVATIVE AND SURGICAL MANAGEMENT.

European Federation of National Associations of Orthopaedics and Traumatology (EFORT) - 12th Congress



Abstract

Introduction

The incidence of spondylolysis is estimated about 5–6% in the general population and accounts for one of the most frequent cause of backpain in the adolescent. The purpose of this study is to present our results from the management of these patients.

Patients and Methods

During the period 1993–2003, 25 children with spondylolysis and spondylolisthesis were managed in our department. Apart from radiographic studies, in cases with a history of acute trauma, a bone scan as well as a CT or MRI scan were performed. There were 13 male and 12 female patients with a mean age of 10.5 years (5–14 years). There were 15 cases of spondylolysis, one at L3 level, 3 at L4 and 11 at L5. 10 patients had spondylolisthesis, 8 of the isthmic type and 2 of the dysplastic type. THe mean follow up of the patients was 6.5 years.

Results

In 24 cases the management was conservative with bedrest until the symproms subsided. Following symptoms resolution a brace was fitted, depending on the case, for 3–6 months. In one case of Grade II spondylolisthesis with nerve root irritation a posterolateral arthrodesis according to Wiltse was performed, following failure of a prolonged period of conservative management.

The results of our patients were evaluated clinically and radiologically according to Seitsalo et al and they were in all cases excellent or good, with full return of the affected children to their previous activities.

Conclusion

In conlusion, spondylolysis and spondylolisthesis is managed conservative in children with good results. Rarely in cases were the symptoms persist despite conservative management, surgical treatment can provide a good result.