All you need to know about pediatric Spondylolisthesis & Spondylolysis

By avn
9:08 am Posted June 3, 2016
In Spondylolysis

Children today are under similar or greater pressure just like that of the adults. They are expected to excel not only in academics but in sports as well. This constant pressure while playing, poor posturing while sitting, studying are few factors, which may lead to spondylosis or spondylolisthesis. Children and younger adults who are athletes specifically in the areas of football, gymnastics, skating, fencing, basketball and baseball are under the risk of developing such a medical criticality of the spine.

Spondylosis

In children, spondylosis may occur because of a stress fracture due to repetitive movement and pressure on the lumbar spine. This particular location, which is the L5 and L4 lumbar vertebrae, are susceptible to injuries or fracture due to continuous flexion, rotation and extension, a characteristic feature of any sport.

Spondylolisthesis

Spondylosis, if left untreated, complicates into spondylolisthesis. This happens when the affected vertebra slips into the vertebra below. If the proportion of this slippage exceeds 50%, the patient is in danger of nerve injury and may experience acute pain. This condition can also be treated conservatively.

Symptoms and causes

A higher level of intensity with which adolescents approach sports and prolonged exposure to strained physical activity may be reasons of spondylosis and progressively spondylolisthesis. Common symptoms include pain of the back and legs. Poor posture and trouble in walking are other problems arising out of spondylosis. In children, 5% of spondylosis cases progresses to spondylolisthesis, however it has been proven that spondylolisthesis can also occur due to a severe spine injury, surgery, tumor, arthritis, or it may also be congenital.

There are six types of spondylolisthesis

  • Type I:
    • Congenital-Birth defect
    • Dysplastic-Developed early in life
  • Type II:
    • Isthmic-Due to pars fracture and instability
  • Type III:
    • Degenerative: Due to severe arthritis
  • Type IV:
    • Traumatic: Due to acute facet fracture
  • Type V:
    • Pathologic: Due to tumor or infection
  • Type VI:
    • Postsurgical: Iatrogenic bone removal

Treatment

The treatment for children suffering from spondylosis and/or spondylolisthesis begins with non-surgical therapies. The type of treatment adopted depends on the severity of the condition and the pain caused. In extreme cases, patients are recommended to be treated with casts or braces, which may help in healing the fractured bone. Physical therapy and oral medications, which include anti-inflammatory medicines, may be prescribed. Epidural steroid injections are given in cases of severe pain and nerve root blocks. Ayurveda and Yoga are two alternative therapies that are quite popular and most sought in the recent times for their holistic non-invasive healing methodologies.

Surgical treatment for children, which is usually the last resort for those kids who find no relief with any of the other treatment options, will include the placement of bone graft and fusing the spine bones together. Metal rods and screws will be used during the surgery for this purpose. This fusion will solidify and hold itself after two or three months from the surgery.

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