Isolated and Multilevel Spondylolysis (Literature Review)

Abstract

One of the main causes of lumbar spine pain is spondylolysis. The purpose of this review is to present the current state of the problem of diagnosis and treatment isolated and multilevel spondylolysis.Materials and Methods. The review includes 86 publications on the problem of spondylolysis for 2005–2019, obtained from electronic databases: PubMed, Cochrane Library, eLIBRARY, CYBERLENINKA.Results. There is still the only known classification of spondylolysis by P. Niggemann et al, which includes four severity of this pathology — from mild to very severe: A, BI, BII, BIII. The classification is based on the nature of changes in the area of bone defect of the vertebral arch when the patient performs functional tests. In some cases, the pathology can be regarded as a transition between different degrees of severity of type B. The treatment of spondylolysis can be both conservative and operational. The conservative therapy consists of physical activity restriction, physiotherapy, wearing a corset, massage, and pharmacotherapy. The purpose of surgical treatment is the removal of fibrous tissue from the zone of spondylolysis and the achievement in this area the bone fusion via a bone autoplasty and(or) osteosynthesis with different metal frameworks. Reasoned arguments about the need for a combination of conservative and surgical treatment of patients with spondylolysis are also reflected in the publications. Information on multilevel spondylolysis is represented by a small number of articles. only 15 authors described clinical cases of multilevel spondylolysis in a total of 21 patients. Spondylolysis is a high risk factor for the spondylolisthesis formation. Among the various categories of patients suffering from spondylolysis and lumbar spondylolysis spondylolisthesis, pregnant women are of particular interest. Hormonal restructuring and changes in the biomechanics of the spine in women during the gestational period often leads to the appearance or intensification pain syndrome in lumbar spine complicating the pregnancy, and hence a fetus development.Conclusion. Timely diagnosis of spondylolysis and the subsequent development of individual rehabilitation not only improves the quality of life of patients, but in some cases can prevent such a serious pathology as spondylolisthesis.