Treating Isthmic Spondylolisthesis
One cause of spinal stenosis (narrowing around the nerve) is spondylolisthesis. A particular type, called isthmic spondylolisthesis, is a very common condition involving a defect in the vertebra (pars defect) that causes instability of the spine. This instability typically affects the bottom of the spine at the L5-S1 and leads to misalignment of the spine, loss of height of the spine and pinching of the spinal nerves. Many people live with isthmic spondylolisthesis for years without experiencing any symptoms. However, symptoms do start appearing more frequently with age, causing patients to begin complaining about back and leg pain as they reach their 50s.
Initially, patients can manage their symptoms with first-level treatments such as anti-inflammatories, physical therapy and activity modification. Sometimes, second-level treatments such as spinal steroid injections are used. But, in some patients, despite extensive non-operative treatment, pain can be so debilitating that it inhibits their quality of life and prevents them from working, caring for loved ones or simply enjoying daily activities. These patients may benefit greatly from spinal fusion, a corrective surgery designed to stabilize the spine and alleviate pinching of the spinal nerve.
The O-Arm Difference
Spinal fusion procedures can be performed in many different ways. The world-renowned surgeons at Emory Orthopaedics & Spine Center always advocate the most effective surgery in the least invasive way possible so patients have less pain and a quicker recovery. In many instances with spondylolisthesis patients, an anterior lumbar interbody fusion (ALIF) is recommended combined with a posterior spinal fusion using O-Arm™ technology.
The O-Arm™ is an intraoperative 3D imaging system that provides real-time, high-quality images during spinal procedures.
This advanced technology allows the surgeons at Emory Healthcare to see the spine virtually using computer imaging and choose the pathway into the spine with the least amount of disturbance to the soft tissues. They are able to leave key muscles and tendons intact because the 3D images from the O-Arm™ reveal the best places to make the smallest possible incisions through the muscles. Then, they can use the computer imaging to accurately place screws and rods into the spine without actually opening the wound (as in traditional surgery).
Before spinal incision is made
Screws and rods have been accurately placed with minimal disturbance to key muscles and tendons with the help of 3D images revealed from the O-Arm.
The surgical team at Emory Orthopaedics & Spine Center has been perfecting its spinal fusion techniques with this newer technology over the past several years. They have found that the O-Arm™ greatly reduces the invasiveness of the surgery, minimizes blood loss, lessens post-operative pain and improves recovery time.
With traditional anterior spine fusion procedures, patients are generally in the hospital for four or five days. That time is reduced significantly with the O-Arm™; some patients are discharged within 24 hours and most are at home and walking well by day two. Often, the only thing patients need is a bit of acetaminophen or other lower-level pain medications to control pain from the incision. They may have some soreness for four to six weeks but should be able to resume very active lives without restrictions once they are completely healed.*
*Not all patients are candidates for minimally invasive surgery, but a detailed consultation with one of our spine surgeons can help determine the optimal procedure for each individual patients unique situation.
How to Refer
To refer a spondylolisthesis patient to the Emory Orthopaedics & Spine Center, call 404-778-3350 and a representative from Emory Healthcare will help schedule an appointment. Patients who have completed initial testing and treatments with their primary care physician will be triaged directly to a surgeon. Those who have not will be scheduled with a nonsurgical specialist for a workup, diagnosis and care plan.
Emory Orthopaedics & Spine Center is committed is committed to the continued health and safety of all patients. During this time, we are taking all necessary precautions to screen for coronavirus (COVID-19) and to prevent its potential spread. We continue to monitor the evolving COVID-19 pandemic and are working with experts throughout Emory Healthcare to keep your patients safe. For the most up-to date information for our referring partners, click here.