the lateral aspect of the superior facet, not inferior facet.
– epidural steroids are more therapeutic than just local block alone and can be done as an outpatient.
– pathophysiology of spondylolytic spondylolisthesis is related to stress fracture.
– clinical presentation of severe L5/S1 spondy – flat buttocks, lumbosacral kyphosis, lumbar lordosis, hip flexion contracture, hamstring spasm, signs of L5 radiculopathy
– Potts disease typically gets T12-L1
– nerve root impingement in the lumbar spine is most likely due to posterolateral disc, hypertrophic facet – most unlikely to be a intradural tumour!
– the young adult who presents with some discomfort and is found to have Scheurmans – observe with physio. They are unlikely to progress once hitting skeletal maturity.
– Scheurermann’s disease treatment begins with physio. Bracing can be used for curves in the 50-70 range, with the goal of achieving a curve near 50 at maturity. For surgery, curves greater than 75 degrees and anterior wedging in excess of 10 tend to lose correction with posterior fixation alone and require anterior surgery.
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