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Spondylolisthesis is when one spinal vertebra slips out of place compared to another. [1] While some medical dictionaries define spondylolisthesis specifically as the forward or anterior displacement of a vertebra over the vertebra inferior to it (or the sacrum), [2] [3] it is often defined in medical textbooks as displacement in any direction.
In cervical spondylosis, a patient may be presented with dull neck pain with neck stiffness in the initial stages of the disease. As the disease progresses, symptoms related to radiculopathy (due to compression of exiting spinal nerve by narrowed intervertebral foramen) or myelopathy (due to compression on the spinal cord) can occur. [2]
Spondylitis; Spondylitis due to Tropheryma whipplei: Contrast-enhanced, T1 weighted fat suppressed magnetic resonance imaging demonstrating contrast enhancing lesions of spondylitis in the first (L1) and second (L2), as well as fourth (L4) and fifth (L5) lumbar vertebra, sparing the intervertebral discs
Weight loss, to relieve symptoms and slow the progression of the stenosis; Physical therapy to support self-care. [37] Also may give instructions on stretching and strength exercises that may lead to a decrease in pain and other symptoms. Lumbar epidural steroid or anesthetic injections have low quality evidence to support their use. [36] [38]
The syndrome occurs in 12% of older community-dwelling men [3] and up to 21% of those in retirement communities. [4] Because the leg symptoms in lumbar spinal stenosis (LSS) are similar to those found with vascular claudication, the term pseudoclaudication is often used for symptoms of LSS. [5]
The part of the spinal cord that was damaged corresponds to the spinal nerves at that level and below. Injuries can be cervical 1–8 (C1–C8), thoracic 1–12 (T1–T12), lumbar 1–5 (L1–L5), [9] or sacral (S1–S5). [10] A person's level of injury is defined as the lowest level of full sensation and function. [11]
Symptoms may be unilateral or bilateral, and correlate to the region of the spine affected. The most common region for spinal disk disease is at L4–L5 or L5–S1. [20] The risk for lumbar disc disease is increased in overweight individuals because of the increased compressive force on the nucleus pulposus, and is twice as likely to occur in men.
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.
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