Secondary vascular disease in spondylolisthesis

Abstract

The topographic relation of the spine to the great vessels let to the expectation that spondylolisthesis may lead to mechanical irritation of the cauda equina as well as of the great vessels. The angiological examination of 223 patients with spondylolisthesis of the lumbar spine shows that the changes in the anatomy of the great vessels are less significant than expected after experiments involving artificial dislocations of the spine in cadavers. In vivo arterial function is not altered even in true spondyloptosis. Pelvic veins on the other hand show considerable compression and diminished flow in third and fourth degree spondylolisthesis of L5 over S1 as well as in second degree spondylolishtesis of L4 over L5. These patients seem to be disposed to venous disorders involving varices and thrombosis. If therefore a high venous pressure is found and a ventral fusion proposed it should be discussed to combine the procedure with a decompression of the veins.