Spondylolysis To Brace or Not To Brace AMSSM 2014
|
|
- Ellen Rose
- 5 years ago
- Views:
Transcription
1 Spondylolysis To Brace or Not To Brace AMSSM 2014
2 Nothing to Disclose Disclosures
3 To Brace? Goals of Treatment History/ Literature of Bracing Mechanics of Bracing Benefits to Brace. Earlier to return to sport?
4 Goals of Treatment Pain Relief / Clinical Healing Radiographic Healing? Reduce Recurrence Minimize long range complications - spinal stenosis? Return to sport. Same level? Time Loss from sport?
5 Acknowledgement. Points of agreement? Rest/ activity modification/cessation of pain provoking activity. Duration? 3-6 months? Less? Core Strengthening/ Hamstring Flexibility Most Clinically do well. Long term sequela - Minimal.
6 To date, there have not been any controlled trials assessing bracing as a treatment for spondylolysis or spondylolisthesis. However, there are studies that support bracing in the setting of acute pars fracture. treatment with brace support is most often applicable to the skeletally immature athlete. bracing in the adult athlete is of limited utility and is typically reserved only for those recreational athletes who are highly symptomatic.
7 Studies/ Reviews that cite Brace Treatment 1980 s Micheli 1980 AJSM 1985 Spine 1985 Orthotics and Prosthetics
8 Studies/ Reviews that cite Brace Treatment 1993 J Spinal Disord. Blanda, et al. Defects of Pars Interarticularis in Athletes: A Protocoal for Nonoperative Treatment 1995 Arch Pediatr Adolesc Med. Micheli & Wood. Back pain in Young Athletes 1995 JBJS Br. Morita, et al. Lumbar spondylolysis in children and adolescents Military Medicine. Daniel, et al. A study of the efficacy of nonoperative treatment of presumed traumatic spondylolysis in a young population. 2001:10 European Spine Journal. Sys, et al. Nonoperative treatment of active spondylolysis in elite athletes with normal X-ray findings:
9 Studies/ Reviews that cite Brace Treatment 2002:25(6) Orthopedics. d Hemecourt, et al. Spondylolysis: returning the athlete to sports participation with brace treatment. 2004;14 Scand J Med Sci Sports. Iwamoto, et al. Returning athletes with severe low back pain and spondylolysis to original sporting activities with conservative treatment. 2004:86 JBJS Br Fujii, et al. Union of defects in the pars interarticularis of the lumbar spine in children and adolescents. 2007:20(8) J Spinal Disord Tech. Kurd, et al. Nonoperative treatment of symptomatic spondylolysis. 2007:6 CSMR McCleary & Congeni. Current Concepts in the Diagnosis and Treatment of Spondylolysis in Young Athletes. 2008:9(2) ISMJ Wicker. FIMS Statement. Spondylolysis and spondylolisthesis in sports.
10 Studies/ Reviews that cite Brace Treatment 2008:16(1) Sports Med Arthrosc Rev. Tallarico, et al. Spondylolysis and Spondylolisthesis in the Athlete. 2008:20 Current Opinion in Pediatrics. Kim & Green. Adolescent Back Pain 2010:92(6) JBJS-B Tsirikos & Garrido. Spondylolysis and Spondylolisthesis in Children and Adolescents 2012: 13(7) Contemporary Spine Surgery Nguyen & Patel. Lumbar Spondylolysis. 2012:25 J Spinal Disord Tech. Sutton, et al. Acute Lumbar Spondylolysis in Intercollegiate Athletes.
11 Below the Belt Phys Med Rehabil Clin N Am Nov;11(4): Spondylolysis. Standaert CJ, Herring SA, Halpern B, King O. Author information Abstract! Spondylolysis is a relatively common incidental radiographic finding that, most frequently, is asymptomatic. Isthmic spondylolysis with a lesion in the pars interarticularis may be a significant cause of pain in a given individual, particularly in adolescent athletes involved in sports with repetitive spinal motions. The pars lesion likely represents a stress fracture of the bone caused by the cumulative effect of repetitive stress imposed by physical activity. The lesion frequently presents as focal LBP and can often be identified on plain radiography. Advanced imaging with SPECT, CT, and MR imaging may be needed to ascertain the acuity of the lesion, assist in identifying a particular pars lesion as potentially symptomatic, and to exclude other spinal pathology that may be present. Conservative treatment is usually successful in controlling symptoms and restoring function; only a small percentage of patients require surgical intervention for pain or progressive spondylolisthesis. Based on current evidence, treatment requires activity restriction (i.e., temporary discontinuation of the aggravating sport or activity) and may require bracing to achieve treatment goals, although healing, pain relief or both may occur without brace application. A full understanding of spinal biomechanics and pathophysiology, the role of diagnostic imaging, and treatment options is needed to care for these patients.! PMID: [PubMed - indexed for MEDLINE]
12 BRACES DO NOT RESTRICT MOTION
13 Articles Frequently Cited as evidence bracing DOES NOT inhibit motion. 1986:11(8) Spine. Lantz and Schultz. Lumbar Spine Orthosis Wearing. Effect on Trunk Muscle Myoelectric Activity. 1992:21(6) Orthopaedic Review. Miller, et al. Lower Spinal Mobility and External Immobilization in the Normal and Pathologic Condition Spine. Axelsson, et al. Effect of Lumbar Orthosis on Intervertebral Mobility.
14 Evidence to support NO BENEFIT? 1992 Orthopaedic Review, Miller x-ray study. 7 patients with listhesis 7 volunteers Average age - 37
15 Evidence to support NO BENEFIT? Cohort - Seven, post-op patients. Surgery for Listhesis grade 1-2. Ages Tantalum indicators were implanted at time of surgery - in the sacrum; and the most proximal vertebra fused. Exam comparisons - supine and erect x-ray exams. NO erect Active Motions performed!!! Results: decrease the overall load on the lumbar spine but no stabilizing effect on the intervertebral mobility.
16 Is this Evidence Applicable to Athletic use of Brace? Can this postop study apply. Negate any possible brace effect in an active athlete? Cohort differences? Post op patients; Listhesis cases. Mobility comparisons? Supine to Erect vs. Active motion of Sport Age (the younger athlete, participating in sport, and due to greater flexibility, is more likely to extend spine SIGNIFICANTLY more than these postop adults. Thereby a brace will probably restrict at least some of the extreme extension of sport). Authors comment: In the current investigation the inter individual variation in mobility as demonstrated by RSA with and without lumbar support was considerable. This might imply that patient characteristics are more important than corset characteristics in spinal immobilization
17 Can These Studies Apply to the Active Athlete??
18 Braces CAN restrict Motion Ultralign provided greater spinal restriction on ROM in all three trunk movements. ProLign LO offered less restriction on the lumbar movements compared to UltraLign LSO, but was still effective in the reduction of lumbar intervertebral segmental mobility compared to the no-brace trials.
19 Journal of Back and Musculoskeletal Rehabilitation Zhang, et al 2006
20 Braces Most Studies of Spine Movement by Braces are intended to assess effect on fracture management at levels higher than L5-S1. These studies HAVE NOT been designed to assess restriction of spine movement during active athletic movement. Mechanical restriction Reminder restriction
21 Bracing: Spine Movements Restricted. Sample of Articles cited. Axelsson P, er al. Effect of lumbar orthosis on intervertebral mobility; A rontgen stereophotogrammetric analysis. Spine 1992;17: Buchalter D, et al. Three-dimensional spinal motion measurements. Part 2: A noninvasive assessment of lumbar brace immobilisation of the spine. J Spinal Disord 1998;1: Fidler MW, et al. The effect of four types of support on the segmental mobility of the lumbosacral spine. JBJS AM 1983;65-A: Lantz SA, et al. Lumbar spine orthosis wearing. I. Restriction of gross body motions. Spine 1986;11:834-7 Mellin G, et al. Effects of subject position on measurements of flexion, extension, and lateral flexion of the spine. Spine 1991;16: Nachemson A, et al. Mechanical effectiveness studies of lumbar spine orthoses. Scand J Rehabil Med Suppl 1983;9: Portek I, et al. Correlation between radiographic and clinical measurement of lumbar spine movement. Br. J Rheumatol 1983;22: Tanz SS, et al. Motion of the Lumbar spine. A roentgenologic study. Am J Roentgenol 1953;69:
22 Studies/ Reviews Questioning Brace Effectiveness for Bone Healing 2009:29(2) J Pediatr Orthop. Klein, et al. Nonoperative Treatment of Spondylolysis in Children and Young Adults. A meta-analysis of Observational Studies. 2011:19 Knee Surg Sports. Alvarez-Diaz., et al. Traumatol Arthrosc. Conservative treatment of lumbar spondylolysis in young soccer players. 2013:92(12) Am J Phys Med Rehab. Rassi et al. Effect of Sports Modification on Clinical Outcome in Children and Adolescent Athletes with Symptomatic Lumbar Spondylolysis.
23 Studies/ Reviews Questioning Brace Effectiveness for Bone Healing Publication liberties??? 2009:29(2) J Pediatr Orthop. Klein, et al. Nonoperative Treatment of Spondylolysis in Children and Young Adults. A meta-analysis of Observational Studies. In this 2009 meta-analysis, the authors cite a 2006 publication by Sairyo. In the text the authors state the use of a corset was discontinued in later studies by the same group BUT, Sairyo s publication on the use of MRI states, The conservative treatment involved asking the patient to stop any sporting activity and to wear a thoracolumbosacral-type trunk brace THERE IS NO MENTION of..corset was discontinued.. in Sairyo s article as was stated by Klein in the 2009 article.
24 Multiple Variables Affect Outcomes Significant factors which affect union following conservative treatment of pars defects of the lumbar spine in 134 children. Local factors Stage of defect Vertebral level Stage of Contralateral defect! Location of defect (L5) - Near Pedicle vs. Isthmus
25 Union of defects in the pars interarticularis of the lumbar spine in children and adolescents. JBJS-Br Fujii, et al. Lumbosacral factors Lumbar lordosis angle (L5 early stage) Lumbar inclination angle (early and progressive stage) Systemic factors Chronological age (L4 progressive stage)
26 Is the benefit of bracing Earlier Return to Sport? 2002:25(6) Orthopedics. d Hemecourt, et al. Spondylolysis: returning the athlete to sports participation with brace treatment. 73 athletes used Boston Brace 6.9 +/- 3.1 months 85% compliance with brace. Return to sport in 4-6 weeks.? lose less muscle mass.
27 Summary Rest/ Activity Modification is Cornerstone of Treatment. No Randomized Clinical Trials Old and Recent Literature suggest bracing. Studies suggesting brace does not restrict MAY NOT apply to sport use. Mechanical AND Reminder Effect.
28 Summary Bracing MAY allow earlier return to sport without compromising outcomes - clinical or radiographic. Timing may significantly influence an athlete s sport progression. The Act of Intervening engages patient and parents in a treatment plan. Compliance with Brace vs. Compliance with Rest? No physical risks/ Modest expense.
Sashil Kapur, MD Sports medicine fellow Lutheran General
Sashil Kapur, MD Sports medicine fellow Lutheran General 1 Spondy-what? Presentation Diagnosis Treatment Return to play 2 Very common musculoskeletal complaint 10-15% of children and adolescents Adults
More informationCase Studies: Low Back Pain in the Athlete. Jim Messerly DO
Case Studies: Low Back Pain in the Athlete Jim Messerly DO Nothing to disclose Case #1 History 15 y/o male presents for evaluation of his low back pain. His pain has been present for several months. The
More information(July, 0) Conflicts of interest All the authors confirm that there are no conflicts of interest with people or organizations that could bias the natur
(July, 0) Bony Healing of Discontinuous Laminar Stress Fractures due to Contralateral Pars Defect or Spina Bifida Occulta Toshinori Sakai, Tsuyoshi Goto, Kosuke Sugiura, Hiroaki Manabe, FumitakeTezuka,
More informationORIGINAL INTRODUCTION MATERIALS AND METHODS. Inclusion and exclusion criteria. The Journal of Medical Investigation Vol
126 ORIGINAL High defect stage, contralateral defects, and poor flexibility are negative predictive factors of bone union in pediatric and adolescent athletes with spondylolysis Kazufumi Yamazaki 1, Shintaro
More informationUSCF 6 th Annual Primary Care Sports Medicine Conference: ABCs of Musculoskeletal Care
USCF 6 th Annual Primary Care Sports Medicine Conference: ABCs of Musculoskeletal Care Back Injuries in the Young Athlete Lyle J. Micheli, MD Mechanism of Injury 1. Acute macrotrauma 2. Repetitive microtrauma
More informationComprehension of the common spine disorder.
Objectives Comprehension of the common spine disorder. Disc degeneration/hernia. Spinal stenosis. Common spinal deformity (Spondylolisthesis, Scoliosis). Osteoporotic fracture. Anatomy Anatomy Anatomy
More informationSpondylolysis. Lysis (Greek λύσις, lýsis from lýein "to separate") refers to the breaking down.
Spondylolysis Lysis (Greek λύσις, lýsis from lýein "to separate") refers to the breaking down. Thomas J Kishen Spine Surgeon Sparsh Hospital for Advanced Surgeries Bangalore Spondylolysis Defect in the
More informationThoracolumbar Spine Conditions: Treatment and Return to Play
Thoracolumbar Spine Conditions: Treatment and Return to Play C H R I S T O P H E R B U R K S, MD B I E N V I L L E O R T H O P A E D I C S P E C I A L I S T S O C E A N S P R I N G S, MS Thoracolumbar
More informationObjectives. Comprehension of the common spine disorder
Objectives Comprehension of the common spine disorder Disc degeneration/hernia Spinal stenosis Common spinal deformity (Spondylolisthesis, Scoliosis) Osteoporotic fracture Destructive spinal lesions Anatomy
More informationThe Athlete s Lumbar Spine: Current Concepts
The Athlete s Lumbar Spine: Current Concepts Content / Objectives Anatomy Common injuries Treatment and prevention Pablo Vazquez Seoane, M.D. 44 th Annual Sports Medicine Symposium January 19 21, 2017
More informationLumbar Disc Replacement FAQs
ISO 9001:2015 FS 550968 What is Lumbar Disc Replacement? The intervertebral discs are the shock absorbers between the bones of the spine. Unfortunately, they often degenerate tearing, bursting, or just
More informationSpineFAQs. Lumbar Spondylolisthesis
SpineFAQs Lumbar Spondylolisthesis Normally, the bones of the spine (the vertebrae) stand neatly stacked on top of one another. The ligaments and joints support the spine. Spondylolisthesis alters the
More informationJBI Database of Systematic Reviews & Implementation Reports 2013;11(9)
Effectiveness of surgical versus conservative treatment for symptomatic unilateral spondylolysis of the lumbar spine in athletes: a systematic review protocol Morné Scheepers 1 MBCHB, BHSC (physio) Manuel
More informationSpondylolysis. Ziva Petrin, MD March 3 rd, 2018
Spondylolysis Ziva Petrin, MD March 3 rd, 2018 Terminology SpondyloLYSIS: Defect in the pars articularis Terminology Spondylolysis àspondylolisthesisà Spondyloptosis https://radiologykey.com/natural-history-of-spondylolysis-and-spondylolisthesis/
More informationASJ. Lumbar Spondylolysis and Spondylolytic Spondylolisthesis: Who Should Be Have Surgery? An Algorithmic Approach. Asian Spine Journal.
Asian Spine Journal 856 Farzad Omidi-Kashani Review Articlet al. Asian Spine J 2014;8(6):856-863 http://dx.doi.org/10.4184/asj.2014.8.6.856 Asian Spine J 2014;8(6):856-863 Lumbar Spondylolysis and Spondylolytic
More informationSpondylolysis DESCRIPTION EXPECTED OUTCOME POSSIBLE COMPLICATIONS COMMON SIGNS AND SYMPTOMS GENERAL TREATMENT CONSIDERATIONS CAUSES
DESCRIPTION is a stress or fatigue fracture of the bones of the spine (vertebrae) that does not involve the main weight-bearing part of those bones, the body of the vertebra. Instead, it involves an area
More informationAltered Biomechanics and Spondylolysis
Altered Biomechanics and Spondylolysis Terry R. Yochum DC, DACBR, Fellow ACCR Alicia M. Yochum RN, DC, DACBR, RMSK Does Altered Biomechanics Cause Bone Marrow Edema? Mark E. Schweitzer, MD and Lawrence
More informationSpondylolysis repair using a pedicle screw hook or claw-hook system. a comparison of bone fusion rates
ORIGINAL ARTICLE SPINE SURGERY AND RELATED RESEARCH Spondylolysis repair using a pedicle screw hook or claw-hook system. a comparison of bone fusion rates Ko Ishida 1), Yoichi Aota 2), Naoto Mitsugi 1),
More informationLumbar epidural hematoma associated with spondylolyses
J Neurosurg Spine 8:174 180, 2008 Lumbar epidural hematoma associated with spondylolyses Report of 3 cases CHIMA O. OHAEGBULAM, M.D., 1 IAN F. DUNN, M.D., 2 PIERRE D HEMECOURT, M.D., 3 AND MARK R. PROCTOR,
More informationUniversity of Jordan. Professor Freih Abuhassan -
Freih Odeh Abu Hassan F.R.C.S.(Eng.), F.R.C.S.(Tr.& Orth.). Professor of Orthopedics University of Jordan 1 A. Sacroiliitis History Trauma is very common Repetitive LS motion--lumbar rotation or axial
More informationBilateral spondylolysis of inferior articular processes of the fourth lumbar vertebra: a case report
Upsala Journal of Medical Sciences. 2012; 117: 72 77 CASE REPORT Bilateral spondylolysis of inferior articular processes of the fourth lumbar vertebra: a case report TOMOAKI KOAKUTSU 1,2, NAOKI MOROZUMI
More informationTest instrument for predicting the effect of rigid braces in cases with low back pain
Prosthetics and Orthotics International, 1990, 14, 22-26 Test instrument for predicting the effect of rigid braces in cases with low back pain S. W. WILLNER Department of Orthopaedics, Malmö General Hospital,
More information3D titanium interbody fusion cages sharx. White Paper
3D titanium interbody fusion cages sharx (SLM selective laser melted) Goal of the study: Does the sharx intervertebral cage due to innovative material, new design, and lordotic shape solve some problems
More informationPatient Selection and Lumbar Operative Interventions
Patient Selection and Lumbar Operative Interventions John C France MD Professor of Orthopaedic & Neurosurgery West Virginia University Low back pain is a symptom not a diagnosis Epidemiology of LBP General
More informationSpondylolysis, a defect in the pars interarticularis of. Multi-level Spondylolysis. A Case Report and Review of the Literature
ulletin of the NYU Hospital for Joint Diseases 2011;69(4):339-43 339 Multi-level Spondylolysis Case Report and Review of the Literature David S. Hersh, M.D., Yong H. Kim, M.D., and fshin Razi, M.D. bstract
More informationA Patient s Guide to Lumbar Spondylolysis. William T. Grant, MD
A Patient s Guide to Lumbar Spondylolysis Dr. Grant is a talented orthopedic surgeon with more than 30 years of experience helping people return to their quality of life. He and GM Pugh, PA-C pride themselves
More informationSignal intensity changes of the posterior elements of the lumbar spine in symptomatic adults
ORIGINAL ARTICLE SPINE SURGERY AND RELATED RESEARCH Signal intensity changes of the posterior elements of the lumbar spine in symptomatic adults Kosuke Sugiura, Toshinori Sakai, Fumitake Tezuka, Kazuta
More informationOrthopadic cors. Topic : -Cervical spondylitis. -Development disorders(spondylolysis and Spodylolsithesis)
Orthopadic cors Topic : -Cervical spondylitis. -Development disorders(spondylolysis and Spodylolsithesis) Cervical spondylitis. Definition : - a painful condition of the cervical spine resulting from the
More informationPediatric Anterior Cruciate Ligament Injuries Is non operative treatment t t an option?
I have no disclosures Pediatric Anterior Cruciate Ligament Injuries Is non operative treatment t t an option? John F. Lovejoy III, MD Chair, Department of Orthopaedics and Sports Medicine Nemours Children
More informationLower Extremity Sports Injuries
Lower Extremity Sports Injuries AAP Musculoskeletal Boot Camp Sigrid F. Wolf, MD Pediatric Sports Medicine Fellow Northwestern University Lurie Children s Hospital Disclosure I have no relevant financial
More informationSpondylolisthesis DESCRIPTION EXPECTED OUTCOME POSSIBLE COMPLICATIONS COMMON SIGNS AND SYMPTOMS GENERAL TREATMENT CONSIDERATIONS CAUSES
DESCRIPTION is the slippage of one or more vertebrae, the bones of the spine. Many causes of slippage of the vertebra are possible; these include stress fracture (spondylolysis), which is often seen in
More informationL5-S1 Spondylolysis/listhesis in children & adolescents: When is surgery indicated? Hubert Labelle, MD
L5-S1 Spondylolysis/listhesis in children & adolescents: When is surgery indicated? Hubert Labelle, MD Wiltse, Newman and Macnab Classification Clin Orthop 1976;117:23-29 Type I: Congenital spondylolisthesis
More informationDominic Carreira M.D. Matt Kruchten, B.S. Fort Lauderdale, FL
Dominic Carreira M.D. Matt Kruchten, B.S Fort Lauderdale, FL Disclosures ConMed Linvatec: Consulting and Education Zimmer Biomet Consulting and Education Royalties for Product Development The hamstring
More informationSpino-pelvic-rhythm with forward trunk bending in normal subjects without low back pain
DOI 10.1007/s00590-013-1303-1 ORIGINAL ARTICLE Spino-pelvic-rhythm with forward trunk bending in normal subjects without low back pain Kiyotaka Hasebe Koichi Sairyo Yasushi Hada Akira Dezawa Yu Okubo Koji
More information3/28/2019. Improving Clinical Diagnostic Decision Making and Treatment for Young Athletes with Low Back Pain. Objectives.
Improving Clinical Diagnostic Decision Making and Treatment for Young Athletes with Low Back Pain Alex Rospert PT, DPT Mitchell Selhorst PT, DPT, OCS Objectives At the end of this session attendees will
More informationPhysical features of pediatric patients with lumbar spondylolysis and effectiveness of rehabilitation
177 ORIGINAL Physical features of pediatric patients with lumbar spondylolysis and effectiveness of rehabilitation Koichi Iwaki, 1 Toshinori Sakai, 2 Daisuke Hatayama, 1 Yohei Hayashi, 1 Nanae Inoue, 1
More information18th International Scientific Meeting of the VCFS Educational Foundation Steven M. Reich, MD. July 15-17, 2011 New Brunswick, New Jersey USA
18th International Scientific Meeting of the VCFS Educational Foundation Steven M. Reich, MD July 15-17, 2011 New Brunswick, New Jersey USA SCOLIOSIS AND ITS TREATMENT Steven M. Reich, MD Assistant Clinical
More informationSpondylolysis: a critical review
Br J Sports Med 2000;34:415 422 415 Review Puget Sound Sports and Spine Physicians, Seattle, Washington, USA and Department of Rehabilitation Medicine, University of Washington, Seattle C J Standaert Puget
More informationCox Technic Case Report #169 published at (sent 5/9/17) 1
Cox Technic Case Report #169 published at www.coxtechnic.com (sent 5/9/17) 1 Management of Lumbar Radiculopathy Associated with an Extruded L4 L5 disc and concurrent L5 S1 Spondylolytic Spondylolisthesis
More informationAm I eligible for the TOPS study? Possibly, if you suffer from one or more of the following conditions:
Am I eligible for the TOPS study? Possibly, if you suffer from one or more of the following conditions: Radiating leg pain Greater leg / buttock pain than back pain Severe pain sets in when walking as
More informationThe imaging features of spondylolisthesis : what the clinician needs to know
The imaging features of spondylolisthesis : what the clinician needs to know Poster No.: C-1018 Congress: ECR 2011 Type: Authors: Educational Exhibit D. Shah 1, C. J. Burke 1, A. C. andi 2, R. Houghton
More informationWhat is the role of imaging in acute low back pain?
Curr Rev Musculoskelet Med (2009) 2:69 73 DOI 10.1007/s12178-008-9037-0 What is the role of imaging in acute low back pain? Humaira Lateef Æ Deepak Patel Published online: 28 April 2009 Ó The Author(s)
More informationLower Back Pain. Sensory motor function. 1 Principles of Exercise Therapy. Global muscles vs Local muscles. Research in Spine Rehabilitation
1 Principles of Exercise Therapy Lower Back Pain 1. Facet joint pain 2. Spondylolysis & Spondylisthesis 1. Exercise Therapy turns the patient into an active participant and not just a passive recipient
More informationInt J Clin Exp Med 2018;11(2): /ISSN: /IJCEM Yi Yang, Hao Liu, Yueming Song, Tao Li
Int J Clin Exp Med 2018;11(2):1278-1284 www.ijcem.com /ISSN:1940-5901/IJCEM0063093 Case Report Dislocation and screws pull-out after application of an Isobar TTL dynamic stabilisation system at L2/3 in
More informationCase Report Lumbar Spondylolysis in Juveniles from the Same Family: A Report of Three Cases and a Review of the Literature
Case Reports in Orthopedics Volume 2013, Article ID 272514, 6 pages http://dx.doi.org/10.1155/2013/272514 Case Report Lumbar Spondylolysis in Juveniles from the Same Family: A Report of Three Cases and
More informationCommon Orthopedic Conditions of the Spine
Common Orthopedic Conditions of the Spine Learning Objective Given a scenario describing a patient with symptoms suggestive of an orthopedic or musculoskeletal condition, formulate a treatment plan after
More informationGeneral Concepts. Growth Around the Knee. Topics. Evaluation
General Concepts Knee Injuries in Skeletally Immature Athletes Zachary Stinson, M.D. Increased rate and ability of healing Higher strength of ligaments compared to growth plates Continued growth Children
More informationTravis Clegg, MD, Leah Carreon, MD, Ian Mutchnick, MD, and Rolando Puno, MD AJO
An Original Study Clinical Outcomes Following Repair of the Pars Interarticularis Travis Clegg, MD, Leah Carreon, MD, Ian Mutchnick, MD, and Rolando Puno, MD Abstract Spondylolysis is a source of back
More informationPatient Information MIS LLIF. Lateral Lumbar Interbody Fusion Using Minimally Invasive Surgical Techniques
Patient Information MIS LLIF Lateral Lumbar Interbody Fusion Using Minimally Invasive Surgical Techniques Table of Contents Anatomy of Spine....2 General Conditions of the Spine....4 What is Spondylolisthesis....5
More informationfactor for identifying unstable thoracolumbar fractures. There are clinical and radiological criteria
NMJ-Vol :2/ Issue:1/ Jan June 2013 Case Report Medical Sciences Progressive subluxation of thoracic wedge compression fracture with unidentified PLC injury Dr.Thalluri.Gopala krishnaiah* Dr.Voleti.Surya
More informationThe Straw that Broke the Child s Back SPORTS Symposium E. John Stanley PT,SCS
The Straw that Broke the Child s Back 2017 SPORTS Symposium E. John Stanley PT,SCS Learning Objectives: 1.Identify 3 characteristics of kids at risk for back injuries. 2.Describe the impact of flexibility,
More informationFacet orientation in patients with lumbar degenerative spondylolisthesis
35 J. Tokyo Med. Univ., 71 1 35 0 Facet orientation in patients with lumbar degenerative spondylolisthesis Wuqikun ALIMASI, Kenji ENDO, Hidekazu SUZUKI, Yasunobu SAWAJI, Hirosuke NISHIMURA, Hidetoshi TANAKA,
More informationAthletic Population with Spondylolysis: Review of Outcomes following Surgical Repair or Conservative Management
THIEME GLOBAL SPINE JOURNAL EBSJ Special Section: Narrative Review 615 Athletic Population with Spondylolysis: Review of Outcomes following Surgical Repair or Conservative Management Pavlos Panteliadis
More informationPediatric and Adolescent Sports ACL Injuries
Pediatric and Adolescent Sports ACL Injuries Stephen K. Aoki, MD Associate Professor University of Utah Department of Orthopaedics Pediatric and Adult Sports Medicine Outline Highlight the following: Differences
More informationAuthor's response to reviews
Author's response to reviews Title: Scoliotic posture as the initial symptom in adolescents with lumbar disc herniation: its curve pattern and natural history after lumbar discectomy Authors: Zezhang Zhu
More informationEvaluation and Management of Knee Pain. Michael Cassat, MD University of Arkansas for Medical Sciences
Evaluation and Management of Knee Pain Michael Cassat, MD University of Arkansas for Medical Sciences Disclosure I have no actual or potential conflict of interest in relation to this program/presentation.
More informationNo Financial Disclosures
Rehabilitation Following Total and Reverse Shoulder Arthroplasty, PT, DPT, SCS, CSCS No Financial Disclosures Total Shoulder Arthroplasty Arthritic shoulder increasing in prevalence More active as we age
More informationFreih Odeh Abu Hassan
Scoliosis Freih Odeh Abu Hassan FRCS(Eng) F.R.C.S.(Eng.), FRCS(Tr&Orth F.R.C.S.(Tr.& Orth.). Professor of Orthopedics University of Jordan Hospital - Amman 1 1-Idiopathic Infantile (0-3 years) Juvenile
More informationOriginal Date: October 2015 LUMBAR SPINAL FUSION FOR
National Imaging Associates, Inc. Clinical guidelines Original Date: October 2015 LUMBAR SPINAL FUSION FOR Page 1 of 9 INSTABILITY AND DEGENERATIVE DISC CONDITIONS FOR CMS (MEDICARE) MEMBERS ONLY CPT4
More informationFirst-Time Anterior Shoulder Dislocation: Is it time to take a stand?
Evaluation and Treatment of the Injured Athlete Martha s Vineyard July 22nd, 2018 First-Time Anterior Shoulder Dislocation: Is it time to take a stand? Robert A. Arciero, MD Professor, Orthopaedics University
More informationLABETTE COMMUNITY COLLEGE BRIEF SYLLABUS. Please check with the LCC bookstore for the required texts for this class.
LABETTE COMMUNITY COLLEGE BRIEF SYLLABUS SPECIAL NOTE: This brief syllabus is not intended to be a legal contract. A full syllabus will be distributed to students at the first class session. TEXT AND SUPPLEMENTARY
More informationLOW BACK PAIN IN THE FEMALE ATHLETE: THROUGH
LOW BACK PAIN IN THE FEMALE ATHLETE: THROUGH C THE AGES Rachel Brakke, MD Assistant Professor University of Colorado School of Medicine- Dept of Physical Medicine and Rehabilitation CU Sports Medicine
More informationIndex. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Adolescent athlete, anatomy and biomechanics of spine of, 424 425 back pain in. See Back pain, in pediatric and adolescent athlete. injury
More informationFunctional Anatomy and Exam of the Lumbar Spine. Thomas Hunkele MPT, ATC, NASM-PES,CES Coordinator of Rehabilitation
Functional Anatomy and Exam of the Lumbar Spine Thomas Hunkele MPT, ATC, NASM-PES,CES Coordinator of Rehabilitation Disclosure Anatomical Review Quick Review of Bony and Ligamentous structures Discal anatomy
More informationAdult Isthmic Spondylolisthesis
Adult Isthmic Spondylolisthesis North American Spine Society Public Education Series What Is Adult Isthmic Spondylolisthesis? The spine is made up of a series of connected bones called vertebrae. In about
More informationFinancial Disclosures. The Unpredictable. Early Onset Idiopathic Scoliosis
Financial Disclosures Vertebral body stapling in children with idiopathic scoliosis < 10 years of age with curve magnitude 30-39 degrees Alexander A. Theologis, MD; Patrick Cahill, MD; Mike Auriemma, BS;
More informationSTAIRS. What s Hip: Top 5 Hip Problems in Primary Care. I have no relevant disclosures. Top 5 (or 6) Pathologies. Big 3- Questions to Ask
I have no relevant disclosures. What s Hip: Top 5 Hip Problems in Primary Care Alan Zhang MD Assistant Professor Sports Medicine and Hip Arthroscopy UCSF Department of Orthopaedic Surgery December, 2015
More informationAnterior Labrum Repair Protocol
Anterior Labrum Repair Protocol Stage I (0-4 weeks): Key Goals: Protect the newly repaired shoulder. Allow for decreased inflammation and healing. Maintain elbow, wrist and hand function. Maintain scapular
More informationCLINICS IN SPORTS MEDICINE
CLINICS IN SPORTS MEDICINE Stress Fractures CONTENTS VOLUME 25 NUMBER 1 JANUARY 2006 Foreword xiii Mark D. Miller Preface Christopher C. Kaeding xv The Pathophysiology of Stress Fractures 1 Michelle Pepper,
More informationSpinal Fusion. North American Spine Society Public Education Series
Spinal Fusion North American Spine Society Public Education Series What Is Spinal Fusion? The spine is made up of a series of bones called vertebrae ; between each vertebra are strong connective tissues
More informationRehab Considerations: Meniscus
Rehab Considerations: Meniscus Steve Cox, PT, DPT Department of Orthopaedics School of Medicine University of Texas Health Science Center at San Antonio 1 -Anatomy/ Function/ Injuries -Treatment Options
More informationProlign. LO Spinal Orthosis. Solace Low Profile Back Brace Maximizing Quality & Comfort. Providing Low Back Pain Relief
Spinal Solutions Solace Low Profile Back Brace Maximizing Quality & Comfort Prolign LO Spinal Orthosis Providing Low Back Pain Relief Soft, breathable material provides a cool, comfortable fit increasing
More informationCruciform anterior spinal hyperextension (CASH) brace with round anterior chest pads.
General Description Thoracolumbar orthoses (TLOs) are used mainly to treat fractures between T10 and L2, because their mobility is not restricted by the ribs, unlike fractures between T2 and T9. Immobilization
More informationDegenerative spondylolisthesis at the L4 L5 in a 32-year-old female with previous fusion for idiopathic scoliosis: A case report
Journal of Orthopaedic Surgery 2003: 11(2): 202 206 Degenerative spondylolisthesis at the L4 L5 in a 32-year-old female with previous fusion for idiopathic scoliosis: A case report RB Winter Clinical Professor,
More informationTherapeutic Exercise And Manual Therapy For Persons With Lumbar Spinal Stenosis
Therapeutic Exercise And Manual Therapy For Persons With Lumbar Spinal Stenosis The program consisted of manual therapy twice per week (eg, soft tissue and neural The components of the Boot Camp Program
More informationPrevalence of Spondylolysis and Spondylolisthesis in Patients Afflicted with Chronic Back Pain in Babol City, Iran, during 2012 and 2013
Prevalence of Spondylolysis and Spondylolisthesis in Patients Afflicted with Chronic Back Pain in Babol City, Iran, during 2012 and 2013 Mahsa Layegh 1, Ebrahim Hejazian 2* 1 Medical Student, Babol University
More informationACL Rehabilitation and Return To Play
ACL Rehabilitation and Return To Play Seth Gasser, MD Director of Sports Medicine Florida Orthopaedic Institute Introduction Return to Play: the point in recovery from an injury when a person is safely
More informationA Patient s Guide to Back Pain in Children
A Patient s Guide to Back Pain in Children 2350 Royal Boulevard Suite 200 Elgin, IL 60123 Phone: 847.931.5300 Fax: 847.931.9072 DISCLAIMER: The information in this booklet is compiled from a variety of
More informationThe Hows and Whys of Back Pain in Young People. Alex Levchenko, DO Interventional Physiatrist October 22, 2017
The Hows and Whys of Back Pain in Young People Alex Levchenko, DO Interventional Physiatrist October 22, 2017 Basics of back pain Relatively common Acute (2-4 weeks duration) Chronic (>13 weeks) Less
More informationPhysical Therapy for the Lower Extremity: What You and Your Patient Should Expect from Rehab
1 Physical Therapy for the Lower Extremity: What You and Your Patient Should Expect from Rehab Thomas Clennell, PT, DPT, SCS Physical Therapist UCSF Benioff Children s Hospital Oakland Sports Medicine
More informationNo Disclosures. Topics. Pediatric ACL Tears
Knee Injuries in Skeletally Immature Athletes No Disclosures Zachary Stinson, M.D. 2 Topics ACL Tears and Tibial Eminence Fractures Meniscus Injuries Discoid Meniscus Osteochondritis Dessicans Patellar
More informationThe Society for Patient Centered Orthopedics. Choosing Wisely List. James Rickert, MD 1
The Society for Patient Centered Orthopedics Choosing Wisely List James Rickert, MD 1 Extremities and Trauma Vertebroplasty Rotator Cuff Repair: For atraumatic (degenerative) tears in patients greater
More informationPersistent Tight Hamstrings Following Conservative Treatment for Apophyseal Ring Fracture in Adolescent Athletes : Critical Appraisal
446 CASE REPORT Persistent Tight Hamstrings Following Conservative Treatment for Apophyseal Ring Fracture in Adolescent Athletes : Critical Appraisal Ryo Miyagi 1, Koichi Sairyo 1, 2, Toshinori Sakai 1,
More informationMedial Meniscal Root Tears: When to rehab? When to repair? When to debride. Christopher Betz, DO Orthopedics Sports Medicine Bristol, CT
Medial Meniscal Root Tears: When to rehab? When to repair? When to debride Christopher Betz, DO Orthopedics Sports Medicine Bristol, CT Disclosure Consultant Mitek Smith and Nephew-biologic patch Good
More informationSpondylolysis is a unilateral or bilateral defect in the. Spondylolysis outcomes in adolescents after direct screw repair of the pars interarticularis
J Neurosurg Spine 21:329 333, 2014 AANS, 2014 Spondylolysis outcomes in adolescents after direct screw repair of the pars interarticularis Clinical article Laura A. Snyder, M.D., 1 Harry Shufflebarger,
More informationInvestigation of the factors to affect the duration to return sports after the surgery of anterior talofibular ligament repair with arthroscopy
Investigation of the factors to affect the duration to return sports after the surgery of anterior talofibular ligament repair with arthroscopy Hamamatsu University School of Medicine Mitsuru Hanada, Shoichi
More informationPROF. EPIMENIO RAMUNDO ORLANDO
PROF. EPIMENIO RAMUNDO ORLANDO Lumbar Spinal Stenosis - Definition N.I.C. caused by lumbar stenosis was firstly described by Verbiest (1954)*1 and is characterized by contemporary single or multiple factors:
More informationOriginal Policy Date
MP 2.01.55 Interventions for Progressive Scoliosis Medical Policy Section Medicine Issue 12:2013 Original Policy Date 12:2013 Last Review Status/Date Reviewed with literature search/12:2013 Return to Medical
More informationInduction and Maintenance of Lordosis in MultiLevel ACDF Using Allograft. Saad Khairi, MD Jennifer Murphy Robert S. Pashman, MD
Induction and Maintenance of Lordosis in MultiLevel ACDF Using Allograft Saad Khairi, MD Jennifer Murphy Robert S. Pashman, MD Purpose Is lordosis induced by multilevel cortical allograft ACDF placed on
More informationA Patient s Guide to Scoliosis
A Patient s Guide to Scoliosis 763 Larkfield Road 2nd Floor Commack, NY 11725 Phone: (631) 462-2225 Fax: (631) 462-2240 DISCLAIMER: The information in this booklet is compiled from a variety of sources.
More informationAnkle Replacement Surgery
Ankle Replacement Surgery Ankle replacement surgery is performed to replace the damaged articular surfaces of the three bones of the ankle joint with artificial implants. This procedure is now being preferred
More informationTreatment Options. CallenChiro.com
Treatment Options Observation One traditional approach to scoliosis has been the wait and see method of observation. This often happens when a scoliosis is detected in a young child, but the curve is not
More informationArtificial intervertebral disc
The University of Toledo The University of Toledo Digital Repository Master s and Doctoral Projects Artificial intervertebral disc Vikas Ghai Medical University of Ohio Follow this and additional works
More informationI have no relevant disclosures pertaining to this talk.
Bryan Houseman, D.O., ATC Orthopaedic Trauma and Fracture Surgeon New Hampshire Orthopaedic Center September 10, 2016 I have no relevant disclosures pertaining to this talk. From Rockwood & Green, 8 th
More informationPediatric Spinal Evaluation for Scoliosis and Back Pain
Pediatric Spinal Evaluation for Scoliosis and Back Pain Jill E. Larson, MD September 29, 2018 Ann & Robert H. Lurie Children s Hospital of Chicago Division of Pediatric Orthopedic Surgery and Sports Medicine
More informationPolicy Number: MCR-067 Revision Date(s): 6/29/12, 9/17/14 This MCR is no longer scheduled for revisions.
Subject: Back Braces Original Effective Date: 5/21/09 Policy Number: MCR-067 Revision Date(s): 6/29/12, 9/17/14 This MCR is no longer scheduled for revisions. Review Date: 12/16/15, 9/15/16, 9/19/17, 3/8/18
More informationA Patient s Guide to Bipartite Patella
A Patient s Guide to Bipartite Patella 651 Old Country Road Plainview, NY 11803 Phone: 5166818822 Fax: 5166813332 p.lettieri@aol.com DISCLAIMER: The information in this booklet is compiled from a variety
More informationSoccer causes degenerative changes in the cervical spine. European Spine Journal, February 2004, 13(1):76-82
Soccer causes degenerative changes in the cervical spine European Spine Journal, February 2004, 13(1):76-82 Alparslan Kartal, Brahim Yldran, Alparslan Enköylü and Feza Korkusuz FROM ABSTRACT: Background
More information