Spondylolisthesis (spaun-di-lo-lie-thee-sis) is a mouthful and is a common cause of low back pain (although it can exist anywhere in the spine, the lumbar spine is the most common area affected). The spinal column is a series of building blocks called vertebral bodies stacked on top of one another. Sometimes these blocks do not line up perfectly. This slight separation in the spinal column is called a spondylolisthesis .
"Doc says I have a spondy-something-or-other. Don't ask me what it is; all I know is that it hurts". Steve tries to explain his low back condition to his friend. But, he finds that he cannot explain what he does not understand. Steve has had back pain for a number of years. Every year the pain gets worse and has now become constant. His doctor sent him for x-rays recently. The x-rays showed a spondylolisthesis with disc degeneration at L5/S1. Steve could not understand his doctor's explanation of the condition. So, now he has pain and has confusion.
Driving a car to the local mechanic to get it fixed is not the same thing as taking the human body into surgery; although, this "fix-it" attitude drives patients and surgeons alike towards surgical solutions. Lately, a growing number of people are undergoing low back surgery . A recent study examined the relationship between patient expectations and the actual outcomes from lumbar spine surgery. Because pre-surgical expectations do not always equate to the actual results, how can a person judge whether or not a surgery was successful? How can one predict surgical success?
Understanding the primary reasons for seeking surgical solutions is the first step towards discussing the likelihood of success. The top three causes for patients wanting lumbar surgery are: 1#, other therapies have failed to help; 2#, the pain is unbearable; 3#, walking has become difficult. Based on these reasons to see a surgeon, patients come to the operating room harboring certain expectations. Patients wa...
Last month, the American Pain Society added to its recommendations to health care providers regarding the diagnosis and treatment of low back pain .
In addition, the Society decided to discuss openly procedures that could be risky to sufferers of low back pain, including recommendations on surgery and other invasive therapies.
Unfortunately, there is not a significant body of good evidence to justify unquestioningly embracing these new recommendations. It is difficult to find well-done clinical studies which support the use of a number of the more invasive treatments used for chronic low back pain.
The initial set of guidelines for the management of chronic low back pain were published in "Annals of Internal Medicine" last October. However, these recommendations dealt more with the initial evaluation of a low back pain patient, and included thoughts on what type of x-rays to order in addition to more conservative treatments such as massage/manipulation and exerci...
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