Explaining Spinal Disorders: Degenerative Spondylolisthesis

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Spondylolisthesis is a spinal condition in which one vertebra slips forward over the vertebra below. Degenerative spondylolisthesis usually occurs in the lumbar (low back) spine, more commonly at L4-L5 (4th and 5th lumbar vertebral levels). Spondylolisthesis can result from degenerative changes in the vertebral structure that causes the joints between the vertebrae to slip forward and may lead to spinal stenosis. Degenerative spondylolisthesis is most common among older female patients, usually over age 60.

Slip of L5 vertebra on sacrum

Symptoms

Some people with spondylolisthesis are symptom-free and discover the disorder when seeing their doctor for another health problem. Symptoms may include:

• Low back pain
• Sciatica ?Muscle spasms
• Leg weakness
• Tight hamstring muscles
• Irregular gait or limp

Diagnosis

Our comprehensive diagnostic process includes:

• Medical history. The doctor asks you questions about your symptoms, their severity, and treatments you have already tried.
• Physical examination. You are carefully examined for limitations of movement, problems with balance, and pain. During the exam, the doctor looks for loss of reflexes, muscle weakness, loss of sensation or other signs of neurological injury.
• Diagnostic tests. Most doctors start with x-rays. Spondylolisthesis is easily seen on a lateral (side) lumbar x-ray. If necessary, a CT scan or MRI may be ordered to see the spine’s tissues in greater detail.

X-ray showing spondylolosthesis

Lumbar spine MRI showing spondylolosthesis

Classification of Spondylolisthesis

Information from your medical file and imaging studies is used to grade the degree of vertebral slippage from mild to severe. The grade of your spondylolisthesis is explained to you along with what it means.

Doctors use the Meyerding Grading System to classify the degree of vertebral slippage. This system is easy to understand. Slips are graded on the basis of the percentage that one vertebral body has slipped forward over the vertebral body below.

• Grade I: 1-24%
• Grade II: 25-49%
• Grade III: 50-74%
• Grade IV: 75%-99% slip.
• Grade V: Complete slip (100%), known as spondyloptosis

Your doctor considers the degree of slip and factors, such as intractable pain and neurological symptoms, when deciding on the most suitable treatment. Most cases of degenerative spondylolisthesis are Grade I or II. As a general guideline, the more severe slips (Grades III and above) are most likely to require surgical intervention.

Nonoperative Treatment

Most cases of degenerative spondylolisthesis are treated without surgery. Treatment may include:

• Short-term bed rest
• Activity restriction
• Over-the-counter or prescription pain medication
• Anti-inflammatory medication
• Muscle relaxants
• Steroid injections (i. e. epidural steroid injection)
• Physical therapy
• Bracing

Degenerative spondylolisthesis can be progressive. This means the spondylolisthesis worsens with time and may cause spinal stenosis. This is why it is important to follow-up with your doctor to monitor your treatment progress and spondylolisthesis.

Surgery

If your degenerative spondylolisthesis progresses or causes neurologic problems, such as incontinence, surgery may be recommended. Spinal instrumentation (i.e. rods, screws) and fusion (bone graft) are common procedures performed to stop slip progression and stabilize the spine. There are different types of instrumentation, bone graft and graft products, as well as procedures (some minimally invasive) to surgically treat degenerative spondylolisthesis. Your surgeon will explain how your surgery will be performed, as well as the benefits and risks of the procedure.

Bone model showing interbody cages, screws and rods

Conclusion 

Degenerative spondylolisthesis does not mean you have to live in pain. We can help you return to a healthy, pain-free and active life. For most patients this is accomplished with nonsurgical treatments. But, even if surgery is needed, be assured we will discuss all procedure risks and benefits and provide you with the best possible care.

In addition treatments, our medical professionals have a deep commitment to patient education. By helping you understand the cause of your condition, we can help you eliminate risk factors and instill spine healthy habits for a lifetime. While you are under our care, our medical staff will provide you with excellent information to help you recover, minimize risk factors, and stay healthy.

Spondylolysis and Spondylolisthesis – OrthoInfo

Spondylolysis (spon-dee-low-lye-sis) and spondylolisthesis (spon-dee-low-lis-thee-sis) are common causes of low back pain in children and adolescents.

Spondylolysis is a weakness or stress fracture in one of the vertebrae, the small bones that make up the spinal column. This condition or weakness can occur in up to 5% of children as young as age 6 with no known injury. A stress fracture can occur in adolescents who participate in sports that involve repeated stress on the lower back, such as gymnastics, football, and weightlifting. In some cases, the stress fracture weakens the bone so much that it is unable to maintain its proper position in the spine — and the vertebra starts to shift or slip out of place. This condition is called spondylolisthesis.

Your spine is made up of 24 small rectangular-shaped bones, called vertebrae, which are stacked on top of one another. These bones connect to create a canal that protects the spinal cord.

Spondylolysis and spondylolisthesis occur in the lumbar spine.

The five vertebrae in the lower back comprise the lumbar spine.

Other parts of your spine include:

Spinal cord and nerves. These “electrical cables” travel through the spinal canal carrying messages between your brain and muscles. Nerve roots branch out from the spinal cord through openings in the vertebrae.

Facet joints. Between and behind adjacent vertebra are small joints that provide stability and help to control the movement of the spine. The facet joints work like hinges, and run in pairs down the length of the spine on each side.

Intervertebral disks. Between the vertebrae are flexible intervertebral disks. These disks are flat and round and about a half-inch thick. Intervertebral disks cushion the vertebrae and act as shock absorbers when you walk or run.

Spondylolysis and spondylolisthesis are different spinal conditions — but they are often related to each other.

Spondylolysis

In spondylolysis, a crack or stress fracture develops through the pars interarticularis (pars fracture). The pars interarticularis is a small, thin portion of the vertebra that connects the upper and lower facet joints.

Most commonly, this fracture occurs in the fifth vertebra of the lumbar spine, although it sometimes occurs in the fourth lumbar vertebra. Fracture can occur on one side or both sides of the bone.

The pars interarticularis is the weakest portion of the vertebra. For this reason, it is the area most vulnerable to injury from the repetitive stress and overuse that characterize many sports.

Spondylolysis can occur in people of all ages without injury or sports participation.

Often, patients with spondylolysis will also have some degree of spondylolisthesis.

Spondylolisthesis

In spondylolisthesis, the fractured pars interarticularis separates, allowing the injured vertebra to shift or slip forward on the vertebra directly below it. In children and adolescents, this slippage most often occurs during periods of rapid growth — such as an adolescent growth spurt.

Doctors commonly describe spondylolisthesis as either low grade or high grade, depending upon the amount of slippage. A high-grade slip occurs when more than 50% of the width of the fractured vertebra slips forward on the vertebra below it. Patients with high-grade slips are more likely to experience significant pain and nerve injury and to need surgery to relieve their symptoms and prevent further deterioration.

(Left) The pars interarticularis is a narrow bridge of bone found in the back portion of the vertebra. (Center) Spondylolysis occurs when there is a fracture of the pars interarticularis. (Right) Spondylolisthesis occurs when the vertebra shifts forward due to instability from the pars fracture.

Overuse

Both spondylolysis and spondylolisthesis are more likely to occur in young people who participate in sports that require frequent overstretching (hyperextension) of the lumbar spine — such as gymnastics, football, and weightlifting. Over time, this type of repetitive activity can weaken the pars interarticularis, leading to fracture and/or slippage of a vertebra.

Genetics

The lower lumbar spine has a risk of developing stress weakness at the location of a spondylolysis in all children, adolescents, and adults who walk upright. Doctors believe that some people may be born with vertebral bone that is thinner than normal — and this may make them more vulnerable to fractures.

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In many cases, patients with spondylolysis and spondylolisthesis do not have any obvious symptoms. The conditions may not even be discovered until an X-ray is taken for an unrelated injury or condition.

When symptoms do occur, the most common symptom is lower back pain. This pain may:

• Feel similar to a muscle strain
• Radiate to the buttocks and back of the thighs
• Worsen with activity and improve with rest

In patients with spondylolisthesis, muscle spasms may lead to additional signs and symptoms, including:

• Back stiffness
• Tight hamstrings (the muscles in the back of the thigh)
• Difficulty standing and walking

Spondylolisthesis patients who have severe or high-grade slips may have tingling, numbness, or weakness in one or both legs. These symptoms result from pressure on the spinal nerve root as it exits the spinal canal near the fracture.

Pain from spondylolysis and spondylolisthesis starts in the center of the lower back and radiates downward.

Physical Examination

Your child’s doctor will begin by taking a medical history and asking about your child’s general health and symptoms. They will want to know if your child participates in sports. Children who participate in sports that place excessive stress on the lower back are more likely to have a diagnosis of spondylolysis or spondylolisthesis.

Your child’s doctor will carefully examine your child’s back and spine, looking for:

• Areas of tenderness
• Limited range of motion
• Muscle spasms
• Muscle weakness

The doctor will also observe your child’s posture and gait (the way they walk). In some cases, tight hamstrings may cause a patient to stand awkwardly or walk with a stiff-legged gait.

Imaging Tests

Imaging tests will help confirm the diagnosis of spondylolysis or spondylolisthesis.

X-rays. X-rays provide images of dense structures, such as bone. The doctor may order X-rays of your child’s lower back from a number of different angles to look for a stress fracture and to view the alignment of the vertebrae.  

If x-rays show a crack or stress fracture in the pars interarticularis portion of the fourth or fifth lumbar vertebra, it is an indication of spondylolysis.

X-ray taken from the side shows a pars fracture in the fifth lumbar vertebra.

Reproduced from Cavalier R, Herman MJ, Cheung EV, Pizzutillo, PD: Spondylolysis and spondylolisthesis in children and adolescents: I. diagnosis, natural history, and nonsurgical management. J Am Acad Orthop Surg 2006; 14: 417-424.

If the fracture gap at the pars interarticularis has widened and the vertebra has shifted forward, it is an indication of spondylolisthesis. An X-ray taken from the side will help your doctor determine the amount of forward slippage.

X-ray taken from the side shows spondylolisthesis in the fifth lumbar vertebra. The white arrow shows the pars fracture. The black arrow shows the direction of the slippage.

Reproduced from JF Sarwark, ed: Essentials of Musculoskeletal Care, ed 4. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010.

Computed Tomography (CT) Scans. Computed tomography combines X-ray with computer technology to produce more detailed images than plain X-rays. CT scans can help your child’s doctor learn more about the fracture or slippage and can be helpful in planning treatment. Because there is more radiation exposure with CT scans than with regular X-rays, however, your child’s doctor may not routinely order this test.

In some cases, a spondylolysis may be discovered in the spine of some teenagers and children when they undergo a CT scan for unrelated reasons, such as abdominal pain or after an accident.

Single Photo Emission Computed Tomography (SPECT) scans. A SPECT scn uses a small amount of radioactive material to identify areas of increased bone activity. When CT scans are not available, a SPECT scan can identify a spondylolysis. This test is no longer used very often, however.

Magnetic Resonance Imaging (MRI) Scans. An MRI scan provides better images of the body’s soft tissues than an X-ray. An MRI can help your child’s doctor determine if there is early degeneration of the intervertebral disks between the vertebrae or if a slipped vertebra is pressing on spinal nerve roots. It can also help the doctor determine if there is injury to the pars interarticularis before it can be seen on X-ray.

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The goals of treatment for spondylolysis and spondylolisthesis are to:

• Reduce pain
• Allow a recent pars fracture to heal
• Return the patient to sports and other daily activities

Nonsurgical Treatment

For most patients with spondylolysis and low-grade spondylolisthesis, back pain and other symptoms will improve with nonsurgical treatment.

Nonsurgical treatment may include:

Rest. Avoiding sports and other activities that place excessive stress on the lower back for a period of time can often help improve back pain and other symptoms.

Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs such as ibuprofen and naproxen can help reduce swelling and relieve back pain.

Physical therapy. Specific exercises can help improve flexibility, stretch tight hamstring muscles, and strengthen muscles in the back and abdomen.

Bracing. Some patients may need to wear a back brace for a period of time to limit movement in the spine and allow a recent pars fracture the opportunity to heal. Although athletes wtih sudden or acute onset of pain are candidates for brace treatment, patients with longer-term pain are not. In these patients, the stress fracture will have a low chance of healing, even after several months in a brace.

Over the course of treatment, your child’s doctor will take periodic X-rays to determine whether the vertebra is changing position.

Surgical Treatment

Surgery may be recommended for spondylolisthesis patients who have:

• Severe or high-grade slippage
• Slippage that is progressively worsening
• Back pain that has not improved after a period of nonsurgical treatment

Spinal fusion between the fifth lumbar vertebra and the sacrum is the surgical procedure most often used to treat patients with spondylolisthesis.

The goals of spinal fusion are to:

• Prevent further progression of the slip
• Stabilize the spine
• Alleviate significant back pain

Surgical Procedure

Spinal fusion is essentially a welding process. The basic idea is to fuse together the affected vertebrae so that they heal into a single, solid bone. Fusion eliminates motion between the damaged vertebrae and takes away some spinal flexibility. The theory is that if the painful spine segment does not move, it should not hurt.

During the procedure, the doctor will first realign the vertebrae in the lumbar spine. Small pieces of bone — called bone graft — are then placed into the spaces between the vertebrae to be fused. Over time, the bones grow together — similar to how a broken bone heals.

Prior to placing the bone graft, your doctor may use metal screws and rods to further stabilize the spine and improve the chances of successful fusion.

In some cases, patients with high-grade slippage will also have compression of the spinal nerve roots. If this is the case, your doctor may perform a procedure to open up the spinal canal and relieve pressure on the nerves before performing the spinal fusion.

(Left) Preoperative X-ray of a 12-year-old spondylolisthesis patient with a painful high-grade slip (arrow). (Right) After spinal fusion and stabilization with rods and screws, the patient’s pain has improved.

Reproduced from Sponsellar PD, Akbamia BA, Lenke LF, Wollowick AL: Pediatric spinal deformity: what every orthopaedic surgeon needs to know. Instru Course Lec, Vol. 61. Rosemont IL. American Academy of Orthopaedic Surgeons, 2012, pp. 481-497.

The majority of patients with spondylolysis and spondylolisthesis are free from pain and other symptoms, sometimes within a few weeks or over several months. In most cases, the patient can gradually resume sports and other activities with few complications or recurrences.

To help prevent future injury, the doctor may recommend that your child do specific exercises to stretch and strengthen the back and abdominal muscles. In addition, your child will need regular check-ups to ensure that problems do not develop.

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Reviewed by members of
POSNA (Pediatric Orthopaedic Society of North America)

The Pediatric Orthopaedic Society of North America (POSNA) is a group of board eligible/board certified orthopaedic surgeons who have specialized training in the care of children’s musculoskeletal health. 

Learn more about this topic at POSNA’s OrthoKids website:

Spondylolysis & Spondylolisthesis

Spondylarthrosis of the lumbosacral spine treatment and prices in Moscow

2 August 2019

91229

3. 8 of 5

Table of contents

• 1 Causes of development
• 2 Types and degrees of spondylarthrosis
• 3 Clinical picture
• 4 Diagnostic methods
• 5 Treatment of spondylarthrosis of the spine
  9 0011 5.1 Medical treatment of spondylarthrosis
  • 5.2 Physiotherapy and exercise therapy
  • 5.3 Surgical treatment of spondyloarthrosis of the lumbosacral spine
• 6 Complications of spondyloarthrosis
• 7 Treatment of spondyloarthrosis at SL Clinic 900 12

A particular form of osteoarthritis, spondyloarthrosis of the spine is a chronic degenerative-dystrophic disease that, in the absence of complex treatment, steadily progresses and can lead to serious consequences over time. The most commonly diagnosed spondyloarthrosis of the lumbar spine, including the lumbosacral. Moderate spondylarthrosis of the thoracic region of the 2nd degree is extremely rarely observed, since this department is rather limited in mobility and does not experience heavy loads.

Destruction of the cartilage tissue of the facet and intervertebral joints is typical for the disease, subsequently the connective tissue and bone structures of the spine are involved in the pathological process. Therefore, the lack of proper attention to it leads initially to a decrease in working capacity, and in advanced cases, to disability. Therefore, it is important to consult a doctor as soon as possible if symptoms of spondylarthrosis of the lumbosacral spine appear.

Specialists of SL Clinic are able to give a full consultation regarding the disease and choose the optimal treatment tactics. Here you will find a warm atmosphere, polite staff and comfortable conditions for the passage of diagnostic and therapeutic procedures.

Causes of development

The disease is age related and is diagnosed in 90% of people over 65 years of age. But recently, there has been a tendency to “rejuvenate” it, since people over the age of 30 often have deforming spondylarthrosis of the lumbar spine and protrusion of the intervertebral discs.

The reasons for this lie in the acceleration of the course of natural degenerative changes in the cartilage tissue. From the age of 25, the percentage of moisture in it decreases, as a result, the cartilage gradually becomes less elastic and durable, and sclerosis foci form in them. Of no small importance is the decrease in motor activity, which leads to the development of congestion and malnutrition of the joints.

Therefore, already at a young age, prerequisites for the development of pathology appear. Significantly increase the likelihood of this:

• osteochondrosis;
• spinal injuries, especially joint subluxations;
• abnormal structure of the spine, including sacralization, lumbarization, asymmetric position of the facet joints and spina bifida;
• markedly obese;
• autoimmune diseases;
• hereditary predisposition.

Particularly great role in the development of spondylarthrosis of the spine. It is typical for him to reduce the height of the intervertebral discs, which leads to a sharp increase in the load on the facet joints and accelerate their wear. This provokes mechanical compression of the vertebrae and their “flattening”, which leads to trophic disturbances and the formation of bone protrusions at their edges. As a result, if, for example, the L5–S1 vertebrae are affected, spondylosis and spondylarthrosis of the lumbosacral spine are already diagnosed.

These processes are accompanied by the manifestation of signs of instability of the joints when turning and bending, limiting the range of motion. Deformation of the periarticular bags provokes the appearance of signs of reactive inflammation, which causes severe pain. Quite often they reach such expressiveness that deprive the person of ability to work.

Types and degrees of spondylarthrosis

Depending on the characteristics of the course of the disease, several types are distinguished, but more often found:

• deforming spondylarthrosis of the lumbosacral spine – accompanied by deformation of the vertebrae by osteophytes;
• degenerative spondylarthrosis – typically destruction of the surfaces of the joints at the junction of the affected vertebra with the ribs and its intervertebral disc;
• polysegmental – diagnosed when the pathological process covers 2 or more departments.

There are 4 stages in the development of the disease. Initial spondyloarthrosis of the lumbosacral spine is not accompanied by changes in the patient’s well-being, but already in the second stage, pain occurs, fatigue increases. This is due to the onset of destruction of the joint and the occurrence of an uneven load on the muscles. As a result, nerves and blood vessels can be pinched, which further aggravates the situation, as the process of collagen formation stops and the elasticity of the cartilage progressively decreases.

At the 3rd stage, cracks form in the cartilage tissue, inflammatory processes join. This leads to the formation of osteophytes of small size and disruption of the ligamentous apparatus.

The 4th stage is considered the most severe, at which, as a result of strong degenerative changes and fusion of the vertebrae, innervation is disturbed and motor functions are turned off, which is an irreversible process. If the disease covered several segments at once, for example, L4–S1 spondylarthrosis was diagnosed, a severe pain syndrome may develop.

Therefore, it is extremely important to diagnose the pathology as early as possible, while there is still a high chance of recovery. An early appeal to the SL-Clinic will help you quickly understand what caused the deterioration of the condition and get the help of highly qualified specialists.

Clinical picture

Since the facet joints are well innervated structures, the most pronounced symptom of the disease is pain. Otherwise, the symptoms of the disease depend on the degree of spondyloarthrosis of the lumbosacral spine. It is characterized by:

• discomfort with prolonged exertion, long sitting or walking;
• sharp pains when turning, bending over, changing body position;
• disorders of posture and gait;
• muscle weakness and morning stiffness;
• discomfort up to severe back pain with movement, change of body position and passing at rest;
• crunch in the back.

Also, the nature of the manifestations of the disease depends on the localization of the affected disc. Therefore, L5–S1 spondyloarthrosis and L3–L4 spondyloarthrosis, especially when nerves are involved in the pathological process, can manifest themselves in different ways. In the first case, discomfort in the lower legs, feet, pelvis will prevail, and in the second, the functions of the genital and urinary organs will most likely suffer.

In some cases, an extensive lesion of the spinal column is diagnosed, for example, spondyloarthrosis of the lumbosacral spine L3–S1. This is manifested by a combination of symptoms, therefore it presents some difficulties in making a preliminary diagnosis. In such situations, patients complain of lower back pain, aggravated by bending, turning, physical work, discomfort in the legs and disruption of the pelvic organs.

Diagnostic methods

Spondylosis, osteochondrosis and spondylarthrosis of the lumbosacral spine are closely related, have similar symptoms and are often observed simultaneously. To differentiate the diagnosis and find out exactly the causes of discomfort, a comprehensive examination is prescribed, including:

• UAC and OAM;
• ultrasound;
• X-ray examination;
• MRI;
• CT;
• radioisotope scanning.

In case of doubt, a diagnostic blockade is recommended. This involves the introduction of an anesthetic directly into the cavity of the affected joint. If at the same time there is a decrease in the severity of the pain syndrome, we can confidently talk about the presence of an inflammatory process.

Treatment of spondylarthrosis of the spine

Treatment of spondylarthrosis, osteochondrosis, spondylosis of the cervical, thoracic and lumbar spine is the task of a vertebrologist. Depending on the severity of the disease, its localization and the degree of destruction of bone structures, patients may be prescribed complex conservative therapy or surgical intervention.

Conservative treatment eliminates the inflammatory process and promotes the restoration of damaged tissues. But even a perfectly matched therapy, including taking medications, physiotherapy and exercise therapy, is not able to lead to a complete recovery. It can only slow down the process of destruction of the joint and improve the patient’s condition.

The operation is prescribed if all attempts to treat spondylarthrosis with injections, physiotherapy and other methods are ineffective.

Medical treatment of spondylarthrosis

Patients are prescribed a complex of drugs that together solve the problem of pain, muscle spasm and help restore cartilage tissue. The list of drugs is selected individually by the vertebrologist and may include:

• NSAIDs;
• antispasmodics;
• corticosteroids;
• muscle relaxants;
• chondroprotectors;
• B vitamins, etc.

Since it takes time for the onset of the effect of chondroprotectors, the first assessment of the therapy is given only after 2–8 weeks. In cases where oral administration of painkillers does not give a pronounced effect, therapeutic blockades are indicated. Injections in the treatment of spondylarthrosis of the lumbosacral spine are performed with a mixture of glucocorticosteroids and analgesics. They quickly eliminate pain, but do not have a therapeutic effect on the joint.

Physiotherapy and exercise therapy

Deforming spondylarthrosis of the lumbar spine that develops against the background of osteochondrosis necessarily requires physiotherapy. The nature and number of procedures is selected individually. Usually assigned:

• laser therapy;
• phonophoresis;
• electrophoresis;
• magnetotherapy;
• ultrasound therapy;
• diadynamic currents.

In the treatment of the disease and the elimination of the risk of its recurrence, exercise therapy plays an important role. An individually selected set of special exercises helps to restore the strength of the muscles responsible for supporting the spine. But in order for physiotherapy exercises to bring noticeable results, you should regularly perform the exercises recommended by a specialist. Each movement should be careful and smooth. If pain occurs, the session should be stopped immediately.

Patients are assigned to wear an orthopedic corset. It supports the spine, reduces the load on the damaged segment and allows the muscles to be in a relaxed state.

Surgical methods of treatment of spondylarthrosis of the lumbosacral spine

Lumbar spondyloarthrosis of 2nd degree or more, associated with severe pain, is successfully treated with the help of destruction of the facet nerves using modern methods:

• radiofrequency ablation;
• cryocoagulation;
• laser vaporization.

Radiofrequency ablation is the most common. The method is based on the principle of thermocoagulation, since when ultra-high frequency currents pass through biological tissues, an active release of thermal energy occurs.

This microsurgical operation is performed using a special electrode that is connected to a generator. After marking, a guide needle is inserted into the soft tissues under image intensifier control exactly assembling from the damaged joint. As soon as it reaches the required area, an electrode is inserted into it. After turning on the device, the nerve ending causing the pain syndrome is quickly heated up to 80 ° C for 1.5 minutes.

As a result, the nerve is coagulated, which usually leads to immediate relief of discomfort. Less commonly, positive changes gradually increase over 6–8 weeks. Modern installations installed in the SL Clinic allow achieving strictly controlled tissue heating, which almost completely eliminates the risk of undesirable consequences.

But radiofrequency ablation gives a pronounced effect, provided that it is performed only in cases where blockades with local anesthetics and steroids bring significant relief. The total duration of the procedure is up to 30 minutes. At the same time, patients can leave the clinic almost immediately after its completion. But until the end of rehabilitation, they are forbidden to lift weights, bend over and actively engage in sports.

In advanced cases, it may also be necessary to:

• Facectomies – removal of the facet joint. The operation is indicated if degenerative changes in it provoke compression of the nerve endings.
• Foraminotomy – expansion of the size of the openings of the vertebrae, in which the nerves pass. It is necessary for compression by bone growths of the nerve roots.
• Laminectomy – resection of part of the vertebra is performed in cases where it puts pressure on the spinal cord.
• Discectomy – removal of part or all of the intervertebral disc.

Open surgeries are mainly performed posteriorly to reduce the risk of spinal cord injury.

Complications of spondylarthrosis

If left untreated, the disease can lead to:

• the formation of intervertebral hernias, in particular spondylarthrosis L4-L5 often leads to the formation of a hernial protrusion in the same segment;
• paralysis;
• scoliosis;
• thrombosis;
• disability.

Treatment of spondylarthrosis at SL Clinic

In order for spondylarthrosis not to provoke the development of irreversible complications, it is necessary to diagnose it as early as possible and take measures to stop the process of joint destruction. Specialists of SL Clinic will help to do this as soon as possible.

The best equipment is installed in the walls of the clinic, with the help of which we can quickly conduct a comprehensive examination of the patient and accurately determine the cause of the pain syndrome. The spinal surgeons of our clinic will be able to eliminate it in the most gentle way. The high professionalism of surgeons allows us to carry out the most complex operations with a high percentage of success and achieve a significant improvement in the condition of patients. With our help, hundreds of patients returned to a full life and forever forgot about the stiffness of movements and discomfort in the back.

Do not put off taking care of your health until later. Sign up for a consultation at SL Clinic right now.

osteochondrosis, spondylosis and spondylarthrosis of the cervical spine, Schmorl’s hernia / Consultation

Question

MRI of the left shoulder joint showed signs of a fracture of the large tubercle of the humerus and a satisfactory condition. fragment. Acromic -cerebrospinal arthrosis. There was 2014 and MRI Shane. Prevention signs of osteochondrosis spondrosis and spondylarthrosis of the cervical spine 2014 and UZDG signs of the right diameter of the indirectness of the course of both PA.2017 and the revenge of the waist spine signs of osteochondrosis are picri CHERT 2CT. GRIZHZH SHMMORLE .2017 and emg conclusion indirect signs of the radicular nature of the process at the L4-L5 level on the left (hypesthesia is noted in the zone of innervation with a normal sensory response along the nerve) i have been treating for many years conservation treatment and rehabilitation and my lower back and night are constantly sore and my back is bad at night. 0003

Zhenya ,
12/25/2018

Reply

Hello Zhenya!
In our Center we treat diseases of the central nervous system and peripheral nerves, surgical treatment of hernias and intervertebral discs.
What is bothering you at the moment? (Pain where and when do they occur? How are they relieved?).
Please send MRI, CT images of the spine to our email address.

Responsible

Shevchenko Elena Nikolaevna
Neurosurgeon of the highest category

Work experience since 1995

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