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Degenerative spondylolisthesis at L5-S1. (A) CT sagittal view of a low grade slip. (B) Lateral radiograph pre-operative intervention. (C) Surgically treated with L5–S1 decompression, instrumented fusion and placement of an interbody graft between L5 and S1. Both minimally invasive and open surgical techniques are used to treat anterolisthesis ...
These cannot be determined by plain films, as the x-ray passes through the soft tissue. A study by Giles et al., stated that sixteen of the thirty patients (53%) had retrolisthesis of L5 on S1 ranging from 2–9 mm; these patients had either intervertebral disc bulging or protrusion on CT examination ranging from 3–7 mm into the spinal canal.
The majority of disc herniations occur in the lumbar spine (95% at L4–L5 or L5–S1). [21] The second most common site is the cervical region (C5–C6, C6–C7). The thoracic region accounts for only 1–2% of cases.
The Napoleon hat sign (most commonly called "inverted Napoleon hat") is a radiologic sign observed on frontal radiographs of the spine at the level of the fifth lumbar vertebra (L5) and the sacrum (S1) that indicates the presence of severe spondylolisthesis and/or severe lumbar lordosis.
The radiation is more attenuated (absorbed) by the denser tissues of the body (i.e. bone) than the softer tissues (i.e. muscles, organs, etc.) creating a picture composed of shades of grey ranging from white to black. A vertebra with a fracture or defect of the pars interarticularis will have a dark mark through this region of bone.
The mammillary is connected in the lumbar region with the back part of the superior articular process. [clarification needed] The accessory process is situated at the back part of the base of the transverse process. The tallest and thickest costiform process is usually that of L5. [2]
Forward displacement of a proximal vertebra in relation to its adjacent vertebra in association with an intact neural arch, and in the presence of degenerative changes, is known as degenerative spondylolisthesis, [9] [10] which narrows the spinal canal, and symptoms of spinal stenosis are common. Of these, neural claudication is most common.
After the conus medullaris (near lumbar vertebral levels 1 (L1) and 2 (L2), occasionally lower), the spinal canal contains a bundle of nerve fibers (the cauda equina or "horse-tail") that branches off the lower end of the spinal cord and contains the nerve roots from L1–L5 and S1–S5. The nerve roots from L4–S4 join in the sacral plexus ...