Severe Spondylolisthesis Pathology Diagnosis Therapy

Only dysplastic (congenital) spondylolisthesis can lead to the complete picture of spondyloptosis. Its therapies are still con­ troversially discussed today. The therapeutic palette ranges from therapeutic nihilism to fusion in situ, to complete reduc­ ti

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Severe Spondylolisthesis

J. HARMS H. STURZ (EDS.)

Severe • S o dylo is eSls Pathology Diagnosis Therapy

With 128 Figures in 226 Separate Illustrations

"

Springer

Prof. Dr. med. JURGEN HARMS Abt. Orthopădie - Traumatologie - Wirbelsăulenchirurgie Klinikum Karlsbad -Langensteinbach Guttmannstr. 1, 76307 Karlsbad, Germany Prof. Dr. med HENNING STURZ Orthopădische Chirurgie - Rheumachirurgie - Sportmedizin Justus-Liebig- Universităt GieBen Paul-Meimberg-Str. 3, 35585 GieBen, Germany

ISBN 978-3-642-63285-3

ISBN 978-3-642-57525-9 (eBook)

DOI 10.1007/978-3-642-57525-9

This work is subject to copyright. AII rights are reserved, whether the whole or part of the material is concerned, specificaIly the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilm or in any other way, and storage in data banks. Duplication of this publicat ion or parts thereof is permitted only under the provisions of the German Copyright Law of September 9, 1965, in its current version, and permission for use must always be obtained from Steinkopff Verlag. Violations are liable for prosecution under the German Copyright Law.

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Originally published by Steinkopff Verlag Darmstadt in 2002 The use of general descriptive names, registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. Product liability: The publishers cannot guarantee the accuracy of any information about the application of operative techniques and medications contained in this book. In every individual case the user must check such informat ion by consult ing the relevant literature. Cover Design: Erich Kirchner, Heidelberg Typesetting: K + V Fotosatz GmbH, Beerfelden SPIN 10772594

105/7231-5 4 3 2 1 0- Printed on acid-free paper

Preface

Only dysplastic (congenital) spondylolisthesis can lead to the complete picture of spondyloptosis. Its therapies are still controversially discussed today. The therapeutic palette ranges from therapeutic nihilism to fusion in situ, to complete reduction of the lumbo-sacral junction. The goal of the symposium, which is presented in this book, was to demonstrate the anatomical and biomechanical fundamental principles which are significant for the selection of the appropriate therapy. With regard to the choice of therapeutic options, no unanimous opinion could be achieved. However, it clearly came to fruition that therapeutic nihilism is not indicated. It was also clearly pointed out that the fusion in situ cannot be considered as the therapy method of choice as progression of the slipping process can occur together with considerable neurological complications despite a long posterior fusion. A particular matter of concern of this symposium was to find out to what extent the local deformity influences the global sagittal profile which is of cru