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Observation, mobilization, and further treatment based on symptoms
68%
2751/4071
Spinal casting and bed rest for 6 weeks
0%
12/4071
Thoracolumbosacral orthosis for 6-8 weeks
24%
960/4071
Open reduction and internal fixation
2%
92/4071
L5 to S1 posterior spinal fusion with instrumentation
6%
235/4071
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Lumbar spondylolysis or spondylolisthesis is present in up to 5% of the population. It is thought to "occur" in the first or second decade and remain asymptomatic in many people until some later event. The first line treatment for adults with spondylolysis or spondylolisthesis is observation, mobilization, and further treatment based on symptoms. Virta et al. report on a cohort of 20 women and 26 men with spondylolisthesis derived from a population of 1147 45 to 64-year-old subjects. Their data suggest that mild-moderate spondylolisthesis detected by chance in a middle-aged population does not predispose to more disabling back pain than controls without spondylolisthesis. They did find however that women with spondylolisthesis had mild back symptoms more often than controls. O'Brien reviews the diagnosis, pathophysiology, progression, and treatment of both isthmic and lytic spondylolisthesis in his 2003 instructional course lecture.
3.1
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