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Spondylolisthesis in children and adolescents
The Journal of Bone and Joint Surgery. British Volume
|November 1, 1977
Summary
Spondylolisthesis progression in pediatric patients is linked to adolescent growth spurts and vertebral anomalies. Early-stage slips (<30%) are unlikely to worsen significantly, guiding treatment decisions.
Area of Science:
- Orthopedics
- Pediatric Spine Surgery
- Radiology
Background:
- Spondylolysis and spondylolisthesis are common spinal conditions in children and adolescents.
- Understanding progression factors is crucial for effective management.
Purpose of the Study:
- To analyze the progression of spondylolisthesis in a pediatric cohort.
- To identify factors influencing vertebral slip progression.
- To evaluate treatment outcomes for decompression and spinal fusion.
Main Methods:
- Retrospective study of 142 pediatric patients with spondylolysis/spondylolisthesis.
- Longitudinal follow-up of 79 patients for over one year.
- Analysis of vertebral slip percentage, presence of anomalies, and treatment interventions.
Main Results:
- Twelve of 79 followed patients showed a 10% or greater vertebral slip increase.
- Progression was most common during the adolescent growth spurt.
- Vertebral anomalies, such as spinal bifida, correlated with increased slip.
- Slips <30% at presentation were unlikely to exceed 30%.
Conclusions:
- Adolescent growth and vertebral anomalies are key factors in spondylolisthesis progression.
- Posterior decompression is recommended for nerve compression.
- Spinal fusion, particularly the intertransverse method, is an effective surgical option.
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