RISK FACTORS AND CONSERVATIVE MANAGEMENT OF SPONDYLOLYSIS AND SPONDYLOLISTHESIS GRADE I AND II

Abstract

Background
 Spondylolysis is a fracture of pars interarticularis without slippage of the vertebral bodies. Spondylolisthesis is anterior slippage of one vertebral body on to the immediate inferior vertebral body. The conservative treatment of spondylolysis and low-grade spondylolisthesis is preferable initial step in the management.
 Objectives 
 The purposes were to find the risk factors for lumbar spondylolysis and spondylolisthesis and the plausibility of conservative management of them.
 Materials and Methods
 Prospective cohort study of a series of (100) patients performed. Each followed up for six consecutive months during 2012-2014. Failure of conservative treatment necessitated surgical intervention. Inclusion criteria for the patients to be included in the study were that the patient needed to be afflicted with Spondylolysis, and/or spondylolisthesis Meyerding grade I and II. We assessed the grades of slippage by Meyerding grading system
 Results
 Patients included in the study were 14% males and 86% females, and the mean and SD (Standard Deviation) age were (43.92±13.83) years. The Body Mass Index (BMI) of the patients were 55% overweight, and 17% obese, with a significant P-value of (<0.001). The mean±SD body height was (166.75±6.94 cm). There was history of trauma in 63% patients, and the level of pars fracture was L5 in 65%, L4 in 30%, and L3 in 4%. The degrees of vertebral slippage were 59% grade I, 34% spondylolysis, 7% grade II. Eleven (11%) of patients were indicated for surgery. Transpedicular screw fixation and fusion was performed for nine patients and two of them refused surgery.
 Conclusion
 Conservative treatment is preferable as an initial step in the management of spondylolysis and spondylolisthesis Grade I and II if there were no neurological deficits.