J Korean Soc Spine Surg.  2001 Mar;8(1):74-80.

Lumbar HIVD Associated with Spondylolysis

• Shin BJ
• Kim KS
• Yun TK
• Lee JC
• Kim KJ
• Kim YI

Abstract

STUDY DESIGN: This is a retrospective study determining the surgical result of lumbar HIVD associated with spondylolysis.
OBJECTIVES
To analyze the incidence of lumbar HIVD associated with spondylolysis and to compare the results of open discectomy for lumbar HIVD associated with spondylolysis to simple lumbar HIVD. SUMMARY OF LITERATURE REVIEW: Lumbar HIVD associated with spondylolysis need be treated by spinal fusion.
MATERIALS AND METHODS
Nine patients(5 males and 4 females) who had lumbar HIVD with spondylolysis, no instability, fol-low-up period of 1yr were identified out of 273 patients with lumbar HIVD, treated by open discectomy from March 1989 to Feb. 1999. The type of HIVD and level of spondylolysis were evaluated, the clinical symptoms and signs including SLR, motor deficit, sensory deficit, change of DTR and severity of radiating pain were periodically followed up on the predesigned protocol.
RESULTS
The incidence of lumbar HIVD associated with spondylolysis is 3.7%. The recovery of back pain was 2.1 to 2.1 by visu-al analogue scale, radiating pain was 7.6 to 0.8. The recovery rate of SLR was 100%, motor deficit; 100%, sensory deficit; 85%, change of DTR; 40%. The clinical evaluation was excellent(2), good(6), fair(1).
CONCLUSIONS
According to the recovery rate of the clinical symptoms, the results of open discectomy for lumbar HIVD associ-ated with spondylolysis without spinal instability and simple HIVD was not different. Therefore, we conclude that lumbar HIVD associated with spondylolysis need not be treated by spinal fusion.

Keyword

Spondylolysis; HIVD; Open discectomy

MeSH Terms

Back Pain
Diskectomy
Humans
Incidence
Male
Retrospective Studies
Spinal Fusion
Spondylolysis*

Figure

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  Fig. 1-A. Plane radiographs of 49 year-old man with herniated intervertebral disc at L4-5 and L5-S1 and spondylosis at L5 show well demarcated pars interarticularis defect(arrow head). Fig. 1-B. After open discectomy of both L4-5, L5-S1 level, spondylolisthetic anterior translation of L4 vertebral body was not occurred on the last follow-up radiographs.

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  Fig. 2. CT image shows that spondylolytic defects have irregular contours, sclerosis, and loss of cortical bone continuity (arrow head).

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  Fig. 3-A, B. T2 weighted sagittal and axial MR images show the herniated intervertebral disc at L4-5, L5-S1 level and a low signal intensity area in the left pars interarticularis of L5(arrow head).

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