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What is anterolisthesis of L3-L4

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Posterior listhesis of a lumbar vertebra in spinal tuberculosis

A 12-year-old Bangladeshi girl with a recent history of pulmonary tuberculosis presented with a 5-day history of immobility, loss of sensation below the mid-thigh bilaterally and bowel and bladder incontinence. She was on anti-tuberculous therapy at admission—rifampicin and isoniazid—for pulmonary tuberculosis diagnosed 4 months previously. Severe lower back and anterior thigh pain had developed 1 month before admission, diagnosed at another centre as tuberculosis of the L2 vertebra; bed rest and continuation of anti-tuberculous therapy was advised at that time. There was no history of traumatic injury. Past medical history revealed a Dandy-Walker cyst, untreated due to lack of parental consent. There was no history of abnormal mental state, but performance in school was subnormal. Examination revealed macrocephaly in keeping with hydrocephalus, but normal higher functions and cranial nerves. Bilateral upper-extremity muscle tone, power, and reflexes were normal. Both lower limbs were wasted without fasciculation but demonstrated hypotonia, grade 0/5 muscle power and areflexia. Abdominal reflexes were present and plantars were down-going bilaterally, but anal reflex was absent. Sensation below the level of L3 was absent on the right and vastly reduced on the left. At the level of L2, gibbus was present with severe tenderness, as well as scoliosis with convexity to the right. Owing to the patient’s ambulatory status, gait was unable to be assessed. Routine hematological and biochemical investigations, including erythrocyte sedimentation rate (ESR), were normal. Plain radiographs of the dorso-lumbar spine (anteroposterior and lateral) revealed Meyerding’s Grade IV posterior listhesis (total intervertebral foramina occlusion) of L2 over L3, with evidence of erosion of the L2 body and pedicle (Fig. ). MRI of the same region demonstrated cauda equina compression, hypointensity of the L2 vertebra, minor hypointense signal changes of the L1 and L3 vertebrae (Fig. ) and bilateral psoas abscesses (Fig. ). Cerebral MRI revealed the Dandy–Walker malformation and hydrocephalus, without peri-ventricular leukomalacia. Both serology and pus drained from the psoas abscesses failed to grow microorganisms, and no acid-fast bacilli were demonstrated on Ziehl–Neelsen staining.

probably led to posterior listhesis of L2 over L3, com-

L4 L5 Retrolisthesis

Marginal osteophytes form around the periphery of the vertebral body end plates of the lumbarspine. The larger ones generally project anteriorly or directly lateral and do not compress neuralstructures. Posterior and posterolateral osteophytes are more likely to cause problems.

Juxtaarticular synovial cysts are associated with facet arthropathy, generally of fairly severedegree. They consist of a fibrous wall, often with a distinct synovial lining, and a cystic center thatmay or may not communicate with the facet joint. They are found most frequently at L4-5, the moremobile segment of the lumbar spine. Synovial cysts can compress the dorsal nerve roots and causeradicular symptoms.

Retrolisthesis of l4 on l5 - Things You Didn't Know

Doctor insights on: Retrolisthesis Of L4 On L5 ..

Symptomatic thoracic disks are uncommon, accounting for about 1% of alldisk herniations. The rib cage, small intervertebral disks, and coronalorientation of the facets joints all contribute to limited mobility of thethoracic spine, and consequently, a lower risk of disk herniation. The mostcommon level is T11-T12, where the spine is relatively less rigid. SagittalT2-weighted FSE sequences are excellent for displaying indentation of ventralthecal sac and impingement of the spinal cord by thoracic disks. Axial imageshelp delineate lateralization to either side. Disk morphology is similarto the cervical region. Calcification is more common in thoracic disk fragmentsand parent disks than in cervical or lumbar region.

occurs in an older age group, usually over 60 years old, and it ismore common in women at the level of L4-L5. It develops when there are severe degenerativechanges and excess motion of the facet joints. Subluxation at the facet joints allows forward orposterior movement of one vertebra over another. A degenerative spondylolisthesis narrows thespinal canal, and symptoms of spinal stenosis are common. Hypertrophic facet arthrosis is a frequentcause of foraminal narrowing.

Retrolisthesis Of L3 On L4 - Ebediyete Kadar
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Grade 1 anterolisthesis of l4 on l5 - Doctor answers

The management of spinal tuberculosis, especially in children, is controversial. In children, vertebral destruction is more severe than adults because of the cartilaginous nature of their bone. Modern chemotherapy has significantly decreased mortality in spinal tuberculosis, but morbidity remains high. Without early surgery, patients can develop severe kyphosis leading to respiratory insufficiency, painful costopelvic impingement and paraplegia. Lumbar kyphosis results in early degenerative lumbar canal stenosis and is cosmetically unacceptable. We report a paediatric case of atypical spinal tuberculosis demonstrating the need for early surgical intervention to prevent significant spinal instability and neurologic deficit. A 12-year-old girl presented with increasing ambulatory difficulty and double incontinence 4 months after initiating treatment for pulmonary tuberculosis. There was no history of traumatic injury. Examination revealed severe lower limb neurologic deficit, with hypotonia, areflexia, marked sensory loss, and grade 0/5 power in both lower limbs. Plain radiographs and magnetic resonance imaging (MRI) demonstrated grade IV posterior listhesis of the L2 vertebral body over L3, cauda equina compression and bilateral psoas abscesses. Erosion of both the body and pedicle of L2 was observed. Both serology and pus drained from the psoas abscesses were negative for microorganisms. The patient underwent an L2 vertebrectomy via a left retroperitoneal approach. A titanium cage packed with autologous bone graft was inserted, and the spine was stabilized by fixation with screw and rods. Histopathology confirmed a diagnosis of tuberculosis. Eighteen months following the procedure, the patient has regained some power in her right leg and has completed her course of anti-tuberculous chemotherapy, but remains wheelchair-bound. To our knowledge, this is the first reported case of posterior listhesis secondary to spinal tuberculosis. Here, we discuss the possible management options in such a case, and the indications for surgery. As the global HIV/AIDS epidemic causes a resurgence in tuberculosis, increased awareness among the medical community regarding the atypical presentations of spinal tuberculosis is necessitated; both in the developing world where advanced clinical presentations are common, and in the developed world where spinal tuberculosis is an often-neglected diagnosis.

Spondylolisthesis | Spine Institute of San Diego

31 Oct 2013 In this video, Bethel Park chiropractor Dr. Kevin Smith (author of the book "Modern Chiropractic: The Way To A Pain-Free Lifestyle") discusses Spinal Stenosis Due To Advanced Degenerative Disc - Cox Technic Disease, Retrolisthesis, And Ankylosing Spondylosis Of The. L2-L3 Segments by. James M. L5 on sacrum. The L3-4 and L4-5 discs are degenerated as well. Degenerative Scoliosis: Lateral Listhesis, Spondylolisthesis 2 Feb 2017 Retrolisthesis. Posterior (backward) “46% percent of patients had lateral listhesis of more than 5 mm at L3 and L4. Curve progression was not pattern of degenerative lumbar retrolisthesis in basrah - IASJ 21 Jun 2015 The L5-S1 followed by the L4-L5 are the most common sites in both sexes . 12.5%. 0.056. 3. 7.5%. 0.052. L3-. L4. Frequency of. Retrolisthesis. chiropractic Care of Retrolisthesis | Spinal Care Clinic Retrolisthesis is reverse spondylolisthesis in which one vertebra slips by the effects of disc degeneration and usually occurs at the L3-4, L4-5, or L4-5 levels.

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