Evidence-Based Health Consult for Lumber Isthmic Spondylolisthesis Grading Ⅱ in Adult: A Case Report_Chinese Journal of Evidence-Based Medicine

Authors：

LUO Xi ,  LI Xiaolin

Nursing College, Sichuan University, Chengdu 610041, China;

Corresponding author：

LI Xiaolin, Email: qling100@163.com

Keywords：

Spondylolisthesis; Adult isthmic; Surgery; Conservative treatment; Evidence-based nursing

DOI：

10.7507/1672-2531.20130021

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective 　To provide evidence-based therapeutic schedule for an adult patient with Lumber Isthmic Spondylolisthesis grading II.
Methods 　Based on fully assessing the patient’s conditions, the clinical problems were put forward according to PICO principles. Such database as The Cochrane Library (2005 to April 2011), DARE (April 2011), CENTRAL (April 2011), MEDLINE (April 2011), EMbase and CBM were searched to collect high quality clinical evidence, and then we told a patient information about treatment plans. The plan was chosen by the patient for she knew her conditions and the plans.
Results 　We included 1 meta-analysis, 3 randomized controlled trials, 5 systematic reviews and 1 prospective study on the natural course of isthmic spondylolisthesis were included. Literature evidence indicated that the prognosis of isthmic spondylolisthesis was good. Surgery should be selected when there was neither no remission of symptom, nor progression of lumber olisthy with conservative treatment. The long-term effect of surgery may be good, but it cannot change the natural course of the disease. Based on literature evidence, the patient chose the conservative treatment. After one year’s treatment the patient recovered, her sciatica relieved, and CT showed no progression of lumber olisthy.
Conclusion 　Patient with low grand isthmic spondylolisthesis chose conservative treatment may achieves good effects, whereas on the process of the treatment, regular follow-up to monitor the progression of lumber olisthy should be conducted.

Citation： LUO Xi,LI Xiaolin. Evidence-Based Health Consult for Lumber Isthmic Spondylolisthesis Grading Ⅱ in Adult: A Case Report. Chinese Journal of Evidence-Based Medicine, 2013, 13(1): 121-124. doi: 10.7507/1672-2531.20130021 Copy

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5.	Jacobs WC, Vreeling A, De Kleuver M. Fusion for low-grade adult isthmic spondylolisthesis: a systematic review of the literature. Eur Spine J, 2006, 15(4): 391-402..
6.	Kwon BK, Hilibrand AS, Malloy K, et al. A critical analysis of the literature regarding surgical approach and outcome for adult low-grade isthmic spondylolisthesis. J Spinal Disord Tech, 2005, 18(Suppl): S30-40.
7.	翟生, 白靖平, 锡林宝勒, 等. 外科治疗成人峡部裂型腰椎滑脱的系统评价. 中国循证医学杂志, 2005, 5(4): 311-317.
8.	Bjarke Christensen F, Stender Hansen E, Laursen M, et al. Long-Term Functional Outcome of Pedicle Screw Instrumentation as a Support for Posterolateral spinal Fusion. Spine, 2002, 27(12): 1269-1277.
9.	McNeely ML, Torrance G, Magee DJ. A systematic review of physiotherapy for spondylolysis and spondylolisthesis. Manual Therapy, 2003, 8(2): 80-91.
10.	Wood KB, Fritzell P, Dettori JR, et al. Effectiveness of spinal fusion versus structured rehabilitation in chronic low back pain patients with and without isthmic spondylolisthesis: a systematic review. Spine (Phila Pa 1976). 2011, 36(21 Suppl): S110-119.
11.	Ibrahim T, Tleyjeh IM, Gabbar O. Surgical versus non-surgical treatment of chronic low back pain: a meta-analysis of randomised trials. International orthopaedics, 2008, 32(1): 107-113.
12.	Ekman P, Möller H, Hedlund R. The long-term effect of posterolateral fusion in adult isthmic spondylolisthesis: a randomized controlled study. Spine J, 2005, 5(1): 36-44.
13.	Ekman P, Möller H, Shalabi A, et al. A prospective randomised study on the long-term effect of lumbar fusion on adjacent disc degeneration. Eur Spine J, 2009, 18(8): 1175-1186.
14.	Beutler KJ, Freddrickson BE, Murtland A, et al. The natural history of spondylolysis and spondylolisthesis: 45-Year follow-up evaluation. Spine, 2003, 28(10): 1027-1035.

1. 董玉雷, 赵宏. 峡部裂型腰椎滑脱的治疗进展. 中国骨与关节外科, 2011, 4(6): 495-500.
2. 赵定麟. 现代脊柱外科学. 第1版. 上海: 上海世界图书出版公司, 2006: 348.
3. McNeely ML, Torrance G, Magee DJ. A systematic review of physiotherapy for spondylolysis and spondylolisthesis. Manual Therapy, 2003, 8(2): 80-91.
4. Lim MR, Yoon SC, Green DW. Symptomatic spondylolysis: diagnosis and treatment. Current Opinion in Pediatrics, 2004, 16(1): 37-46.
5. Jacobs WC, Vreeling A, De Kleuver M. Fusion for low-grade adult isthmic spondylolisthesis: a systematic review of the literature. Eur Spine J, 2006, 15(4): 391-402..
6. Kwon BK, Hilibrand AS, Malloy K, et al. A critical analysis of the literature regarding surgical approach and outcome for adult low-grade isthmic spondylolisthesis. J Spinal Disord Tech, 2005, 18(Suppl): S30-40.
7. 翟生, 白靖平, 锡林宝勒, 等. 外科治疗成人峡部裂型腰椎滑脱的系统评价. 中国循证医学杂志, 2005, 5(4): 311-317.
8. Bjarke Christensen F, Stender Hansen E, Laursen M, et al. Long-Term Functional Outcome of Pedicle Screw Instrumentation as a Support for Posterolateral spinal Fusion. Spine, 2002, 27(12): 1269-1277.
9. McNeely ML, Torrance G, Magee DJ. A systematic review of physiotherapy for spondylolysis and spondylolisthesis. Manual Therapy, 2003, 8(2): 80-91.
10. Wood KB, Fritzell P, Dettori JR, et al. Effectiveness of spinal fusion versus structured rehabilitation in chronic low back pain patients with and without isthmic spondylolisthesis: a systematic review. Spine (Phila Pa 1976). 2011, 36(21 Suppl): S110-119.
11. Ibrahim T, Tleyjeh IM, Gabbar O. Surgical versus non-surgical treatment of chronic low back pain: a meta-analysis of randomised trials. International orthopaedics, 2008, 32(1): 107-113.
12. Ekman P, Möller H, Hedlund R. The long-term effect of posterolateral fusion in adult isthmic spondylolisthesis: a randomized controlled study. Spine J, 2005, 5(1): 36-44.
13. Ekman P, Möller H, Shalabi A, et al. A prospective randomised study on the long-term effect of lumbar fusion on adjacent disc degeneration. Eur Spine J, 2009, 18(8): 1175-1186.
14. Beutler KJ, Freddrickson BE, Murtland A, et al. The natural history of spondylolysis and spondylolisthesis: 45-Year follow-up evaluation. Spine, 2003, 28(10): 1027-1035.

Chinese Journal of Evidence-Based Medicine

Evidence-Based Health Consult for Lumber Isthmic Spondylolisthesis Grading Ⅱ in Adult: A Case Report

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