Escolar Documentos
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Pathology
Clinical features
Imaging
Management
Microdiscectomy
Postoperative rehabilitation and physiotherapy are essential
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Spinal stenosis
Spondylolisthesis
Lytic - 50%
Degenerative - 25%
Post-traumatic
Pathological
Postoperative
In lytic spondylolisthesis the pars interarticularis is in two pieces
(spondylolysis)
Vertebral body and superior facet joints subluxate and dislocate forward
Degree of overlap is usually expressed as percentage
Cauda equina or nerve roots may be compressed
Presents with back pain and neurological symptoms
Patients have a characteristic stance
A 'step' in the lumbar spine may be palpable
Diagnosis can be confirmed on a plain x-ray
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Bibliography
Deyo R A, Weinstein J N. Low Back Pain. N Engl J Med 2001; 344: 363-370.
Hagen H D, Hilde G, Jamtvedt G, Winnem M. Bed rest for acute low back
pain. Cochrane Database Syst Rev 2000; 2: CD001254.
Koes B W, van Tulder M W, Thomas S. Diagnosis and treatment of low back
pain. BMJ 2006; 332: 1430-1434.
Nelemas P J, de Bie R A, de Vet H C, Sturmans F. Injection therapy for
subacute and chronic low back pain. Cochrane Database Syst Rev 2000; 2:
CD001824.
van Tulder M W, Scholten R J, Koes D C V, Deyo R A. Non-steroidal antiinflammatory drugs for low back pain. Cochrane Database Syst Rev 2000; 2:
CD000396.