Authors: Marco Crostelli Osvaldo Mazza
Publish Date: 2012/05/09
Volume: 22, Issue: 2, Pages: 172-184
Abstract
The association of scoliosis and spondylolisthesis is well documented in literature the nature and modalities of the relationship of the two pathologies are variable and not always clear Also etiologic particulars of scoliosis associated with spondylolisthesis are not well defined even in cases where scoliosis is called idiopathic In this paper we review previous literature and discuss the different aspects of the mutual relationship of scoliosis and spondylolisthesis in the adolescent ageIt is a common notion that the highest occurrence of scoliosis associated with spondylolisthesis is at the lumbar level both in adolescent and in adult patients It is probable that the scoliosis that is more heavily determined by the presence of spondylolisthesis is at the lumbar level and presents curve angle lower than 15° Cobb and mild rotation The scoliosis with curve value over 15° Cobb that is present at the lumbar level in association with spondylolisthesis probably is not prominently due to spondylolisthesis in these cases spondylolisthesis is probably only partially responsible for scoliosis progression with a spasm mechanism and/or due to rotation of slipping “olisthetic” vertebraWe think that the two pathologies should be treated separately as stated by many other authors but we would highlight the concept that whatever be the scoliosis curve origin spasm olisthetic or mixed together this origin has no influence on treatment The curves should be considered for all practical effects as socalled idiopathic scoliosis We think that generally patient care should be addressed to treat only spondylolisthesis or only scoliosis if it is necessary on the basis of clinical findings and therapeutic indications of the isolated pathologies completely separating the two diseases treatmentsScoliosis should be considered as an independent disease only in the case of scoliosis curve progression over time associated scoliosis must be treated according to therapeutic principles of the care of any socalled idiopathic scoliosis of similar magnitude and a similar approach must be applied in the case of spondylolisthesis progression or painful spondylolisthesis
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