I would prefer looking above vertebra's as well.if you look closely there seems a disc bulgeL1 also
L4-5 spondylolisthesis, too. Definitely calls for a PLIF for that level, at least.
Respectfully that is a somewhat blanket statement. Presumably the patient has symptomatic spinal stenosis/neurogenic claudication. The literature is fairly clear that the amount of canal narrowing on MRI does not correlate clinically. Additionally, although patients with stenosis and degenerative spondylolisthesis generally have symptoms of NIC, the amount of listhesis also is irrelevant.
Now, some patients do great with decompression surgery and I am not saying it is not indicated in this case. Rather, and providing the patient has no hard neuro findings, I would hope a long trial of conservative therapy be done prior to considering surgery.
Sounds like this has been stable for sometime, are you trying to pad the pockets of an associate in pain management? :) Just kidding, he's already making plenty from him/her. Chiropractor might be as well.
Spondylolisthesis. I had it, had alif/ plif but mine was l6-S1 because my sacrum formed wrong is now corrected to L5-S1..
We call that a 360° fusion 5/1
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