Spondylolisthesis - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

SPONDYLOLISTHESIS A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES J ...

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SPONDYLOLISTHESIS A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2004 by ICON Group International, Inc. Copyright 2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Spondylolisthesis: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-84635-9 1. Spondylolisthesis-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International, Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on spondylolisthesis. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON SPONDYLOLISTHESIS ................................................................................. 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Spondylolisthesis........................................................................... 4 The National Library of Medicine: PubMed .................................................................................. 7 CHAPTER 2. NUTRITION AND SPONDYLOLISTHESIS ....................................................................... 51 Overview...................................................................................................................................... 51 Finding Nutrition Studies on Spondylolisthesis ......................................................................... 51 Federal Resources on Nutrition ................................................................................................... 52 Additional Web Resources ........................................................................................................... 52 CHAPTER 3. CLINICAL TRIALS AND SPONDYLOLISTHESIS ............................................................. 55 Overview...................................................................................................................................... 55 Recent Trials on Spondylolisthesis .............................................................................................. 55 Keeping Current on Clinical Trials ............................................................................................. 56 CHAPTER 4. PATENTS ON SPONDYLOLISTHESIS ............................................................................. 59 Overview...................................................................................................................................... 59 Patents on Spondylolisthesis........................................................................................................ 59 Patent Applications on Spondylolisthesis.................................................................................... 64 Keeping Current .......................................................................................................................... 65 CHAPTER 5. BOOKS ON SPONDYLOLISTHESIS ................................................................................. 67 Overview...................................................................................................................................... 67 Book Summaries: Online Booksellers........................................................................................... 67 The National Library of Medicine Book Index ............................................................................. 67 Chapters on Spondylolisthesis ..................................................................................................... 68 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 73 Overview...................................................................................................................................... 73 NIH Guidelines............................................................................................................................ 73 NIH Databases............................................................................................................................. 75 Other Commercial Databases....................................................................................................... 77 The Genome Project and Spondylolisthesis.................................................................................. 77 APPENDIX B. PATIENT RESOURCES ................................................................................................. 81 Overview...................................................................................................................................... 81 Patient Guideline Sources............................................................................................................ 81 Finding Associations.................................................................................................................... 84 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 87 Overview...................................................................................................................................... 87 Preparation................................................................................................................................... 87 Finding a Local Medical Library.................................................................................................. 87 Medical Libraries in the U.S. and Canada ................................................................................... 87 ONLINE GLOSSARIES.................................................................................................................. 93 Online Dictionary Directories ..................................................................................................... 94 SPONDYLOLISTHESIS DICTIONARY ..................................................................................... 95 INDEX .............................................................................................................................................. 117

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with spondylolisthesis is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about spondylolisthesis, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to spondylolisthesis, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on spondylolisthesis. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to spondylolisthesis, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on spondylolisthesis. The Editors

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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON SPONDYLOLISTHESIS Overview In this chapter, we will show you how to locate peer-reviewed references and studies on spondylolisthesis.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and spondylolisthesis, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “spondylolisthesis” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •

Conservative Management for Spondylolysis and Spondylolisthesis Source: Journal of Musculoskeletal Medicine. 13(6):12; June 1996. Summary: This journal article describes the diagnosis, symptoms, and treatment options for the spinal problems of spondylolysis and spondylolisthesis. The author indicates that surgery is seldom necessary, with management being directed at alleviating any symptoms. Supportive measures include anti-inflammatories, short rest periods, aerobic exercise, and physical therapy. Surgical infusion may be considered if nonoperative care is ineffective.

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Federally Funded Research on Spondylolisthesis The U.S. Government supports a variety of research studies relating to spondylolisthesis. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to spondylolisthesis. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore spondylolisthesis. The following is typical of the type of information found when searching the CRISP database for spondylolisthesis: •

Project Title: ASSESS & IMPROVE THE QUALITY OF CARE FOR LOW BACK PAIN Principal Investigator & Institution: Birkmeyer, Nancy J.; Community and Family Medicine; Dartmouth College 11 Rope Ferry Rd. #6210 Hanover, Nh 03755 Timing: Fiscal Year 2002; Project Start 15-SEP-2000; Project End 31-AUG-2005 Summary: As reflected in the-topic of this proposal, the applicant has two main career goals: (I) to evaluate the quality of surgical and non-surgical treatment for low back pain; and (2). to reduce variation in treatment practices and improve the outcomes of treatment for these conditions. This five-year project combines the use of outcomes research and continuous quality improvement techniques to close the gap between knowledge gained through outcomes research and clinical practices to improve outcomes for patients with low back pain. Despite its frequency and related costs, little is known about the quality of care for spinal disorders. The data and infrastructure provided by the recently initiated Spine Patient Outcomes Research Trials (SPORT) presents a unique opportunity to study, compare, and improve outcomes for patients undergoing treatment for three surgically treatable spine conditions: herniated disc, spinal stenosis, and degenerative spondylolisthesis. SPORT is a set of clinical trials to compare the effectiveness of surgical and non-surgical approaches to the treatment of these conditions that is being conducted at II U.S. medical centers and expects to enroll approximately 3000 patients. The overall goals of this proposal are to evaluate and improve the quality of care for low back pain through a comparative study of the structure, process, and outcomes of care at medical centers participating in SPORT. Specifically, this proposal has three research objectives: 1. To characterize clinical practices. We plan a detailed study of variability in structures and processes of care for patients with low back pain at the sites participating in SPORT. 2. To assess outcomes of care. After developing and validating methods for risk-adjustment, we will evaluate and compare quality of care for low back pain across the II sites participating in SPORT. Outcomes, to be assessed in both surgically and non-surgically treated patients, will include functional health status, clinical outcomes, patient satisfaction, and cost. 3. To

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Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

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link clinical practices and outcomes. Using statistical models to account for random variation in the setting of hierarchical data structures, we will examine associations between clinical structure, process, and outcomes to identify high-leverage areas for improvement. Improving clinical care can not occur in the vacuum of a research laboratory. At each step of this project, we will feedback data to clinicians at the participating medical centers and work with them to develop a focused quality improvement agenda that is designed to improve patient outcomes by reducing variability in clinical practices. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CLINICAL DECISION MAKING IN LOW BACK PAIN Principal Investigator & Institution: Lurie, Jon D.; Medicine; Dartmouth College 11 Rope Ferry Rd. #6210 Hanover, Nh 03755 Timing: Fiscal Year 2002; Project Start 01-SEP-2002; Project End 31-AUG-2007 Summary: (provided by applicant): The applicant has the broad career goal of improving the diagnostic evaluation, treatment recommendations, and health outcomes for patients with low back pain. In this project he proposes to extend his prior training in outcomes research, technology assessment, medical decision-making, and biostatistics. These advanced quantitative skills will be used to identify optimal treatment strategies for subgroups of low back pain patients defined on the basis of clinical and radiologic features. Low back pain is one of the most prevalent and costly health problems in the industrial world. Back surgery is nearly always elective, yet the rates of spine surgery in the US have increased dramatically in the past 10 years and show marked geographic variation. Both the First and Second International Forums for Primary Care Research on Low Back Pain chose the identification of important clinical subgroups of low back pain patients based on characteristics, imaging studies and other factors as their number one research priority. The data and infrastructure provided by the recently initiated Spine Patient Outcomes Research Trial (SPORT) presents a unique opportunity to study the predictors of outcome for patients with herniated discs, spinal stenosis, and degenerative spondylolisthesis. SPORT is a set of clinical trials designed to compare the effectiveness of surgical and non-surgical approaches to the treatment of these conditions; it is being conducted at I I U.S. medical centers and expects to enroll approximately 3000 patients. Extensive clinical, functional status, quality of life, and imaging data will allow for an unprecedented ability to identify optimal treatment approaches for these patients. This five-year project combines the use of outcomes research and decision analytic techniques to better understand the predictors of outcome with surgery and non-surgical treatment. After a period of additional training in decision in mdeling and biostatistics, the applicant will work closely with the Principal Investigator and Co-Principal vestigators of SPORT to accomplish two specific research objectives: To identify patient subgroups, defined by clinical and radiographic features at baseline, that are predictive of good/bad outcome with surgical/nonsurgical treatment among patients with intervertebral disc herniation, spinal stenosis, or degenerative spondylolisthesis with associated stenosis. To develop decision analytic models for specific patient subgroups, which also accommodate individual patient preference and quality of life data, for the purpose of identifying optimal treatment strategies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: MECHANISMS OF SPECIFIC TRUNK EXERCISES IN LOW BACK PAIN Principal Investigator & Institution: Henry, Sharon M.; Physical Therapy; University of Vermont & St Agric College 340 Waterman Building Burlington, Vt 05405 Timing: Fiscal Year 2003; Project Start 24-MAR-2003; Project End 29-FEB-2008 Summary: (provided by applicant): Poor neuromuscular control, such as delayed muscle recruitment or alterations in levels of muscle activation, can lead to abnormal loads on joints and ligaments of the spine, leading to spinal instability and lower back pain (LBP). Active contraction of trunk muscles helps to control inter-segmental movement and stability in the lumbar spine by adding stiffness to the trunk. Muscle dysfunction associated with LBP has been thought to involve deep, local trunk muscles the transversus abdominis (TA) and multifidus muscles. These muscles are hypothesized to provide stability to the lumbar spine. Treatments which focus on retraining TA and multifidus by using low level isometric contractions of these specific deep trunk muscles during particular tasks and functional activities have been effective at reducing LBP and improving function for selected subgroups of LBP subjects. The precise muscle dysfunction associated with LBP has not been satisfactorily characterized, in part because muscles such as TA and multifidus are difficult to characterize directly given their anatomical location. However, analytical modeling can assist in characterizing these deeper muscles. A more complete characterization of the function of these muscles can lead to more precise treatments of LBP. The three major aims of this project are: 1) to characterize the pre-treatment motor control alterations (alterations in muscle latencies or in modulation of muscle activity level) in subjects with spondylolisthesis and mechanical LBP compared to healthy control subjects, and to determine whether specific deep trunk-muscle exercises (low level isometric contractions of TA and multifidus) improve these alterations compared to a general exercise protocol. We hypothesize that prior to treatment, muscle latencies will be earlier in LBP groups compared to the control group and that the latencies will improve (increase) in LBP subjects receiving specific trunk exercise protocol but not in subjects receiving a general exercise protocol at all time points post-treatment; 2) to employ biomechanical modeling to study mechanisms underlying these specific deep trunk muscle exercises. We hypothesize that increased activation of TA and multifidus muscles increases stability of the trunk by reducing intervetebral motion; and 3) to determine the effects of specific trunk exercises compared to more general strengthening and endurance exercises on pain and function during activities of daily living in the LBP subjects. We hypothesize that subjects in a specific exercise protocol will have decreased pain and increased functional ability compared to subjects in a general exercise protocol, at all time points post-treatment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: SAFETY OF LUMBAR FUSION SURGERY FOR CHRONIC BACK PAIN Principal Investigator & Institution: Mirza, Sohail K.; Associate Professor; Orthopaedics/Sports Medicine; University of Washington Grant & Contract Services Seattle, Wa 98105 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 30-JUN-2007 Summary: (provided by applicant): Although I have been successful as a spine surgeon in an academic environment, building a respected clinical practice and completing spine biomechanics research for competitively funded projects, I realize that clinical research

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most directly addresses my motivation for choosing an academic career, and that highquality clinical research is complex, requiring a long-term commitment and specialized skills. I am in an excellent environment to develop these skills, with supportive colleagues and a supportive chairman. I have developed a five-year training schedule, with the first three years devoted to obtaining an MPH degree. A team of three outstanding individuals has committed to working with me for the next five years and guiding my career development. My immediate goal is to gain practical clinical research experience by conducting a five-year prospective study with this team of experienced and highly respected researchers. My long-term career goals are to help identify spine patient populations more concretely, measure end-results of spinal disorders in general, and define outcomes for treated and untreated back pain and whiplash injuries in particular. Research Project: The use of surgery for back pain is rapidly growing; data on its safety and outcomes are sorely needed. We propose a prospective cohort study to measure the frequency of complications in lumbar fusion surgery, variation in rates of specific serious complications with different types of lumbar fusion, clinical and functional consequences for specific types of complications, and patient or treatment characteristics that predict particularly severe complications. Over a two-year interval, we propose to enroll 1000 patients choosing fusion surgery for treatment of disc degeneration, spondylolisthesis, spinal stenosis, and adult degenerative scoliosis. We will follow these patients for two years, measure predictor patient and treatment characteristics, and measure consequences with clinical and functional outcomes. Accumulating data will be stored in an existing central database. The analysis will use appropriate univariate and multivariate techniques to address the study questions. This study will provide data on the relative benefits and risks of lumbar fusion surgery in treating back pain. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.3 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with spondylolisthesis, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “spondylolisthesis” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for spondylolisthesis (hyperlinks lead to article summaries):

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PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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A case of spontaneous cure of spondylolisthesis in adolescence. Author(s): Silvello L, Vercellesi E. Source: Ital J Orthop Traumatol. 1980 August; 6(2): 235-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7216726

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A clinical study of degenerative spondylolisthesis. Radiographic analysis and choice of treatment. Author(s): Satomi K, Hirabayashi K, Toyama Y, Fujimura Y. Source: Spine. 1992 November; 17(11): 1329-36. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1462209

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A comparative study of spondylolisthesis in operations on adolescents and adults. Author(s): Haraldsson S, Willner S. Source: Archives of Orthopaedic and Trauma Surgery. 1983; 101(2): 101-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6847346

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A comparison of the effectiveness of spinal manipulative therapy for low back pain patients with and without spondylolisthesis. Author(s): Vernon H. Source: Journal of Manipulative and Physiological Therapeutics. 1987 December; 10(6): 337-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2963886

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A comparison of the effectiveness of spinal manipulative therapy for low back pain patients with and without spondylolisthesis. Author(s): Mierau D, Cassidy JD, McGregor M, Kirkaldy-Willis WH. Source: Journal of Manipulative and Physiological Therapeutics. 1987 April; 10(2): 49-55. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2953840

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A comparison of the long term results of three types of posterior fusion of the lumbar spine for spondylolisthesis. Author(s): Suezawa Y, Bernoski FP, Jacob HA. Source: International Orthopaedics. 1981; 5(4): 291-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7341514

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A family with spondylolisthesis. Author(s): Shahriaree H, Sajadi K, Rooholamini SA. Source: The Journal of Bone and Joint Surgery. American Volume. 1979 December; 61(8): 1256-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=511891

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A new method for the radiographic evaluation of spondylolisthesis. Author(s): Capasso G, Zanchini M. Source: Ital J Orthop Traumatol. 1987 June; 13(2): 227-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3451920

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A new technique for the reduction and stabilisation of severe spondylolisthesis. A report of nine cases. Author(s): Sijbrandij S. Source: International Orthopaedics. 1985; 9(4): 247-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4093226

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A new technique for the reduction and stabilisation of severe spondylolisthesis. A report of two cases. Author(s): Sijbrandij S. Source: The Journal of Bone and Joint Surgery. British Volume. 1981 August; 63-B(2): 266-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7217154

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A new type of distractor for the surgical correction of scoliosis and spondylolisthesis. Author(s): Manaresi C. Source: Ital J Orthop Traumatol. 1979 December; 5(3): 267-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=553913

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A newly devised "three-one" method for the surgical treatment of spondylolysis and spondylolisthesis. Author(s): Takeda M. Source: Clinical Orthopaedics and Related Research. 1980 March-April; (147): 228-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6989541

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A radiologic sign in spondylolisthesis. Author(s): Ravichandran G. Source: Ajr. American Journal of Roentgenology. 1980 January; 134(1): 113-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6766001

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A systematic review of physiotherapy for spondylolysis and spondylolisthesis. Author(s): McNeely ML, Torrance G, Magee DJ. Source: Manual Therapy. 2003 May; 8(2): 80-91. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12890435

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Abnormalities of the soleus H-reflex in lumbar spondylolisthesis: a possible early sign of bilateral S1 root dysfunction. Author(s): Mazzocchio R, Scarfo GB, Cartolari R, Bolognini A, Mariottini A, Muzii VF, Palma L. Source: Journal of Spinal Disorders. 2000 December; 13(6): 487-95. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11132979

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Achievement of normal sagittal plane alignment using a wedged carbon fiber reinforced polymer fusion cage in treatment of spondylolisthesis. Author(s): Brantigan JW, Neidre A. Source: The Spine Journal : Official Journal of the North American Spine Society. 2003 May-June; 3(3): 186-96. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14589199

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Acquired spondylolisthesis following scoliosis surgery. A case report. Author(s): Friedman RJ, Micheli LJ. Source: Clinical Orthopaedics and Related Research. 1984 November; (190): 132-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6488622

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Acquired spondylolysis and spondylolisthesis in the young child. Author(s): Wertzberger KL, Peterson HA. Source: Spine. 1980 September-October; 5(5): 437-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7455774

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Acute spondylolytic spondylolisthesis. Risk of progression and neurological complications. Author(s): Hilibrand AS, Urquhart AG, Graziano GP, Hensinger RN. Source: The Journal of Bone and Joint Surgery. American Volume. 1995 February; 77(2): 190-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7844124

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Adding posterior lumbar interbody fusion to pedicle screw fixation and posterolateral fusion after decompression in spondylolytic spondylolisthesis. Author(s): Suk SI, Lee CK, Kim WJ, Lee JH, Cho KJ, Kim HG. Source: Spine. 1997 January 15; 22(2): 210-9; Discussion 219-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9122804

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Adult spondylolisthesis treated with posterolateral lumbar fusion and pedicular instrumentation with AO DC plates. Author(s): Thalgott JS, Sasso RC, Cotler HB, Aebi M, LaRocca SH. Source: Journal of Spinal Disorders. 1997 June; 10(3): 204-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9213275

Studies

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An anatomic evaluation of L5 nerve stretch in spondylolisthesis reduction. Author(s): Petraco DM, Spivak JM, Cappadona JG, Kummer FJ, Neuwirth MG. Source: Spine. 1996 May 15; 21(10): 1133-8; Discussion 1139. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8727186

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An unusual reduction technique prior to surgical treatment for traumatic spondylolisthesis in the lower cervical spine. Author(s): Ido K, Murakami H, Kawaguchi H, Urushidani H. Source: Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia. 2002 November; 9(6): 664-6; Discussion 667. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12604279

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Analysis and treatment of poor outcomes following in situ arthrodesis in adolescent spondylolisthesis. Author(s): Newton PO, Johnston CE 2nd. Source: Journal of Pediatric Orthopedics. 1997 November-December; 17(6): 754-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9591977

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Anterior fibular strut grafting for the treatment of pseudoarthrosis in spondylolisthesis. Author(s): Majd ME, Holt RT. Source: Am J Orthop. 2000 February; 29(2): 99-105. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10695860

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Anterior interbody fusion versus posterolateral fusion with transpedicular fixation for isthmic spondylolisthesis in adults. A comparison of clinical results. Author(s): Kim NH, Lee JW. Source: Spine. 1999 April 15; 24(8): 812-6; Discussion 817. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10222534

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Anterior interbody fusion with and without interspinous block implementation for lumbar isthmic spondylolisthesis. Author(s): Tsuji H, Ishihara H, Matsui H, Hirano N, Ohshima H. Source: Journal of Spinal Disorders. 1994 August; 7(4): 326-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7949700

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Anterior spinal fusion for spondylolysis and isthmic spondylolisthesis. Long term results in adults. Author(s): Cheng CL, Fang D, Lee PC, Leong JC. Source: The Journal of Bone and Joint Surgery. British Volume. 1989 March; 71(2): 264-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2925745

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Spondylolisthesis

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Anterior spondylodesis for spondylolisthesis: isthmic and degenerative types. Author(s): Moon MS, Kim SS, Sun DH, Moon YW. Source: European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 1994; 3(3): 172-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7866831

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Atlanto-occipital fusion and spondylolisthesis in an Anasazi skeleton from Bright Angel Ruin, Grand Canyon National Park, Arizona. Author(s): Merbs CF, Euler RC. Source: American Journal of Physical Anthropology. 1985 August; 67(4): 381-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4061591

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Beware of spondylolisthesis. Author(s): Weisenberger BL. Source: J Occup Med. 1968 March; 10(3): 121-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4230706

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Biochemical changes of intervertebral discs in patients with spondylolisthesis or with tears of the posterior annulus fibrosus. Author(s): Roberts S, Beard HK, O'Brien JP. Source: Annals of the Rheumatic Diseases. 1982 February; 41(1): 78-85. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7065733

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Biomechanics of grade I degenerative lumbar spondylolisthesis. Part 1: in vitro model. Author(s): Crawford NR, Cagli S, Sonntag VK, Dickman CA. Source: Journal of Neurosurgery. 2001 January; 94(1 Suppl): 45-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11147867

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Biomechanics of grade I degenerative lumbar spondylolisthesis. Part 2: treatment with threaded interbody cages/dowels and pedicle screws. Author(s): Cagli S, Crawford NR, Sonntag VK, Dickman CA. Source: Journal of Neurosurgery. 2001 January; 94(1 Suppl): 51-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11147868

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Brace treatment for symptomatic spondylolisthesis. Author(s): Bell DF, Ehrlich MG, Zaleske DJ. Source: Clinical Orthopaedics and Related Research. 1988 November; (236): 192-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3180570

Studies

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Buck's operation for treatment of spondylolysis and spondylolisthesis. Author(s): Beckers L. Source: Acta Orthop Belg. 1986; 52(6): 819-23. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3564916

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Case report 868. Congenital bilateral spondylolysis and spondylolisthesis of the fourth cervical vertebra. Author(s): Jeyapalan K, Chavda SV. Source: Skeletal Radiology. 1994 October; 23(7): 580-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7824992

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Case report. Neurofibromatosis with lumbosacral spondylolisthesis. Author(s): Winter RB, Edwards WC. Source: Journal of Pediatric Orthopedics. 1981; 1(1): 91-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6804491

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Caso quiz. Degenerative spondylolisthesis at L4. Author(s): Laus M, Tigani D, Pignatti G, Alfonso C, Giunti A. Source: Chir Organi Mov. 1994 January-March; 79(1): 133-6. English, Italian. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8076472

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Cauda equina lesions following fusion in situ and decompressive laminectomy for severe spondylolisthesis. Four case reports. Author(s): Maurice HD, Morley TR. Source: Spine. 1989 February; 14(2): 214-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2538003

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Cauda equina syndrome after in situ arthrodesis for severe spondylolisthesis at the lumbosacral junction. Author(s): Schoenecker PL, Cole HO, Herring JA, Capelli AM, Bradford DS. Source: The Journal of Bone and Joint Surgery. American Volume. 1990 March; 72(3): 369-77. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2312532

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Cervical spondylolisthesis and other skeletal abnormalities in Rubinstein-Taybi syndrome. Author(s): Robson MJ, Brown LM, Sharrard WJ. Source: The Journal of Bone and Joint Surgery. British Volume. 1980 August; 62(3): 2979. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7410460

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Cervical spondylolisthesis associated with the multiple nevoid basal cell carcinoma syndrome. Author(s): Barnes DA, Borns P, Pizzutillo PD. Source: Clinical Orthopaedics and Related Research. 1982 January-February; (162): 2630. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7067221

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Cervical spondylolisthesis. Author(s): Kosnik EJ, Johnson JC, Scoles PV, Rossel CW. Source: Spine. 1979 May-June; 4(3): 203-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=472891

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Cervical spondylolisthesis. A case report. Author(s): Ferriter PJ, O'Leary P, Block J, Fielding JW. Source: Spine. 1984 November-December; 9(8): 830-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6528297

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Changes of the sacrum in severe spondylolisthesis: a possible key pathology of the disorder. Author(s): Takahashi K, Yamagata M, Takayanagi K, Tauchi T, Hatakeyama K, Moriya H. Source: Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association. 2000; 5(1): 18-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10664435

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Chiropractic management of spondylolisthesis with spondylolysis of the pars interarticularis: an example of the single-case study experimental design. Author(s): Crawford JP, Noble WJ, Vernon H. Source: Journal of Manipulative and Physiological Therapeutics. 1988 April; 11(2): 89-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2968432

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Classification of spondylolisis and spondylolisthesis. Author(s): Wiltse LL, Newman PH, Macnab I. Source: Clinical Orthopaedics and Related Research. 1976 June; (117): 23-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1277669

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Clinical and pathologic correlations in traumatic spondylolisthesis of the axis. Author(s): Sherk HH, Howard T. Source: Clinical Orthopaedics and Related Research. 1983 April; (174): 122-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6831795

Studies

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Clinical results of a single central interbody fusion cage and transpedicle screws fixation for recurrent herniated lumbar disc and low-grade spondylolisthesis. Author(s): Huang KF, Chen TY. Source: Chang Gung Med J. 2003 March; 26(3): 170-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12790220

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Closed reduction of spondylolisthesis. An experience in 22 patients. Author(s): Bradford DS. Source: Spine. 1988 May; 13(5): 580-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3187703

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Colonic perforation complicating posteroanterior fusion using fibular strut autograft for a high-grade spondylolisthesis. Author(s): Shindle MK, Khanna AJ, Hoehner JC, O'Neill PJ, Sponseller PD. Source: Journal of Spinal Disorders & Techniques. 2002 December; 15(6): 546-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12468988

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Combined neurosurgical-orthopedic approach to the correction of radiculopathy and instability in spondylolysis and spondylolisthesis. Author(s): Johnson AC, Power TC. Source: Int Surg. 1984 October-December; 69(4): 345-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6526630

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Comment on topographic relations of neural and ligamentous structures of the lumbosacral junction: in vitro investigation. Spondylolisthesis--no reduction, partial reduction or total reduction? Author(s): Mulholland RC. Source: European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 2001 April; 10(2): 133-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11345634

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Comparison between posterolateral fusion with pedicle screw fixation and anterior interbody fusion with pedicle screw fixation in adult spondylolytic spondylolisthesis. Author(s): Suk KS, Jeon CH, Park MS, Moon SH, Kim NH, Lee HM. Source: Yonsei Medical Journal. 2001 June; 42(3): 316-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11456398

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Comparison of the results of spinal fusion for spondylolisthesis in patients who are instrumented with patients who are not. Author(s): Chang P, Seow KH, Tan SK. Source: Singapore Med J. 1993 December; 34(6): 511-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8153712

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Competitive sports and the progression of spondylolisthesis. Author(s): Muschik M, Hahnel H, Robinson PN, Perka C, Muschik C. Source: Journal of Pediatric Orthopedics. 1996 May-June; 16(3): 364-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8728639

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Complications associated with posterior lumbar interbody fusion using Bagby and Kuslich method for treatment of spondylolisthesis. Author(s): Chen L, Tang T, Yang H. Source: Chinese Medical Journal. 2003 January; 116(1): 99-103. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12667398

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Complications in the surgical treatment of pediatric high-grade, isthmic dysplastic spondylolisthesis. A comparison of three surgical approaches. Author(s): Molinari RW, Bridwell KH, Lenke LG, Ungacta FF, Riew KD. Source: Spine. 1999 August 15; 24(16): 1701-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10472105

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Computed tomography in spondylolisthesis. Author(s): McAfee PC, Yuan HA. Source: Clinical Orthopaedics and Related Research. 1982 June; (166): 62-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7083687

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Computed tomography of spondylolisthesis: patterns of associated pathology. Author(s): Elster AD, Jensen KM. Source: Journal of Computer Assisted Tomography. 1985 September-October; 9(5): 86774. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4031164

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Concomitant discitis and spondylolisthesis at adjacent lumbar vertebrae. Author(s): Loder RT, Birch JG, Johnston CE 2nd. Source: Orthopedics. 1986 February; 9(2): 283-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3960769

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Congenital spondylolisthesis in the upper spinal column. Management of two cases. Author(s): Tokgozoglu AM, Alpaslan AM. Source: Spine. 1994 January 1; 19(1): 99-102. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8153816

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Correlation of pelvic incidence with low- and high-grade isthmic spondylolisthesis. Author(s): Hanson DS, Bridwell KH, Rhee JM, Lenke LG. Source: Spine. 2002 September 15; 27(18): 2026-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12634563

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Cost-effectiveness of fusion with and without instrumentation for patients with degenerative spondylolisthesis and spinal stenosis. Author(s): Kuntz KM, Snider RK, Weinstein JN, Pope MH, Katz JN. Source: Spine. 2000 May 1; 25(9): 1132-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10788859

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Current evaluation and management of spondylolysis and spondylolisthesis. Author(s): McTimoney CA, Micheli LJ. Source: Curr Sports Med Rep. 2003 February; 2(1): 41-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12831675

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Decompression and luque rectangle fusion for degenerative spondylolisthesis. Author(s): Knox BD, Harvell JC Jr, Nelson PB, Hanley EN Jr. Source: Journal of Spinal Disorders. 1989 December; 2(4): 223-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2535282

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Decompression in the surgical management of degenerative spondylolisthesis: advantages of a conservative approach in 290 patients. Author(s): Krengel W. Source: Journal of Spinal Disorders. 1999 February; 12(1): 80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10078956

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Decompression in the surgical management of degenerative spondylolisthesis: advantages of a conservative approach in 290 patients. Author(s): Epstein NE. Source: Journal of Spinal Disorders. 1998 April; 11(2): 116-22; Discussion 123. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9588467

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Degenerative cervical spondylolisthesis: diagnosis and management in five cases. Author(s): J Neurosurg. 1996 Dec;85(6):1198 Source: Journal of Spinal Disorders. 1996 June; 9(3): 241-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8929526

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Degenerative lumbar spondylolisthesis with spinal stenosis, a prospective study comparing decompression with decompression and intertransverse process arthrodesis: a critical analysis. Author(s): Vaccaro AR, Garfin SR. Source: Spine. 1997 February 15; 22(4): 368-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9055361

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Degenerative lumbar spondylolisthesis with spinal stenosis. A prospective study comparing decompression with decompression and inter-transverse process arthrodesis. Author(s): Healey JH. Source: The Journal of Bone and Joint Surgery. American Volume. 1992 June; 74(5): 792. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1624496

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Degenerative lumbar spondylolisthesis. A meta-analysis of literature 1970-1993. Author(s): Mardjetko SM, Connolly PJ, Shott S. Source: Spine. 1994 October 15; 19(20 Suppl): 2256S-2265S. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7817240

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Degenerative lumbar spondylolisthesis: a meta-analysis of literature 1970-1993. Author(s): Mulholland RC. Source: Spine. 1995 September 1; 20(17): 1957-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8560349

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Degenerative lumbar spondylolisthesis-induced radicular compression: nonfusionrelated decompression in selected patients without hypermobility on flexionextension radiographs. Author(s): Kristof RA, Aliashkevich AF, Schuster M, Meyer B, Urbach H, Schramm J. Source: Journal of Neurosurgery. 2002 October; 97(3 Suppl): 281-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12408380

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Degenerative spondylolisthesis at the L4-L5 in a 32-year-old female with previous fusion for idiopathic scoliosis: a case report. Author(s): Winter RB, Silverman BJ. Source: Journal of Orthopaedic Surgery (Hong Kong). 2003 December; 11(2): 202-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14676348

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Degenerative spondylolisthesis. Author(s): Bolesta MJ, Bohlman HH. Source: Instr Course Lect. 1989; 38: 157-65. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2649568

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Degenerative spondylolisthesis. Developmental or acquired? Author(s): Love TW, Fagan AB, Fraser RD. Source: The Journal of Bone and Joint Surgery. British Volume. 1999 July; 81(4): 670-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10463743

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Degenerative spondylolisthesis: developmental or acquired. Author(s): Mooney V. Source: The Journal of Bone and Joint Surgery. British Volume. 2000 March; 82(2): 307-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10755450

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Diagnosis and treatment of severe dysplastic spondylolisthesis. Author(s): Leone LD, Lamont DW. Source: J Am Osteopath Assoc. 1999 June; 99(6): 326-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10405520

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Direct pediculo-body fixation in cases of spondylolisthesis with advanced intervertebral disc degeneration. Author(s): Grob D, Humke T, Dvorak J. Source: European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 1996; 5(4): 281-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8886744

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Direct repair of defect in lumbar spondylolysis and mild isthmic spondylolisthesis by bone grafting, with or without facet joint fusion. Author(s): Dai LY, Jia LS, Yuan W, Ni B, Zhu HB. Source: European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 2001 February; 10(1): 78-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11276840

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Direct repair of spondylolysis without spondylolisthesis, using a rod-screw construct and bone grafting of the pars defect. Author(s): Gillet P, Petit M. Source: Spine. 1999 June 15; 24(12): 1252-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10382254

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Direct repair of the pars interarticularis for spondylolysis and spondylolisthesis. Author(s): Lundin DA, Wiseman D, Ellenbogen RG, Shaffrey CI. Source: Pediatric Neurosurgery. 2003 October; 39(4): 195-200. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12944700

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Disc degeneration in young patients with isthmic spondylolisthesis treated operatively or conservatively: a long-term follow-up. Author(s): Seitsalo S, Schlenzka D, Poussa M, Osterman K. Source: European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 1997; 6(6): 393-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9455667

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Distinction between degenerative and isthmic spondylolisthesis on sagittal MR images: importance of increased anteroposterior diameter of the spinal canal ("wide canal sign"). Author(s): Ulmer JL, Elster AD, Mathews VP, King JC. Source: Ajr. American Journal of Roentgenology. 1994 August; 163(2): 411-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8037041

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Dowel fibular strut grafts for high-grade dysplastic isthmic spondylolisthesis. Author(s): Hanson DS, Bridwell KH, Rhee JM, Lenke LG. Source: Spine. 2002 September 15; 27(18): 1982-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12634557

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Early halo immobilization of displaced traumatic spondylolisthesis of the axis. Author(s): Vaccaro AR, Madigan L, Bauerle WB, Blescia A, Cotler JM. Source: Spine. 2002 October 15; 27(20): 2229-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12394899

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Early sacral stress fracture after reduction of spondylolisthesis and lumbosacral fixation: case report. Author(s): Fourney DR, Prabhu SS, Cohen ZR, Gokaslan ZL, Rhines LD. Source: Neurosurgery. 2002 December; 51(6): 1507-10; Discussion 1510-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12445359

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Editorial: Spondylolisthesis. Author(s): Nachemson A, Wiltse LL. Source: Clinical Orthopaedics and Related Research. 1976 June; (117): 2-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1277666

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Effect of major axial skeleton trauma on preexisting lumbosacral spondylolisthesis. Author(s): Floman Y, Margulies JY, Nyska M, Chisin R, Libergall M. Source: Journal of Spinal Disorders. 1991 September; 4(3): 353-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1802165

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Effects of slip severity and loading directions on the stability of isthmic spondylolisthesis: a finite element model study. Author(s): Natarajan RN, Garretson RB 3rd, Biyani A, Lim TH, Andersson GB, An HS. Source: Spine. 2003 June 1; 28(11): 1103-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12782976

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Efficacy of flexion and extension treatments incorporating braces for low-back pain patients with retrodisplacement, spondylolisthesis, or normal sagittal translation. Author(s): Spratt KF, Weinstein JN, Lehmann TR, Woody J, Sayre H. Source: Spine. 1993 October 1; 18(13): 1839-49. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8235870

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Electro-neurophysiological diagnosis by the approach from single nerve root unit in the degenerative spondylolisthesis. Author(s): Matsuda H, Hirose T, Shimazu A, Yoshimura M, Yamano Y, Nakajima K. Source: Osaka City Med J. 1977; 23(2): 155-65. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=616581

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Epidural lipoma causing a myelographic block in a patient who had sciatica and lumbosacral spondylolisthesis. A case report. Author(s): Supik LF, Broom MJ. Source: The Journal of Bone and Joint Surgery. American Volume. 1991 August; 73(7): 1104-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1874777

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Epidurography in lumbar spondylolisthesis. Author(s): Johansen JG, Hauge O. Source: Neuroradiology. 1982; 23(2): 101-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7078719

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Etiology of spondylolisthesis. Author(s): Taillard WF. Source: Clinical Orthopaedics and Related Research. 1976 June; (117): 30-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1277680

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Etiology of spondylolisthesis. Assessment of the role played by lumbar facet joint morphology. Author(s): Grobler LJ, Robertson PA, Novotny JE, Pope MH. Source: Spine. 1993 January; 18(1): 80-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8434330

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Spondylolisthesis

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Evaluation and management of spondylolysis and spondylolisthesis. Author(s): Stillerman CB, Schneider JH, Gruen JP. Source: Clin Neurosurg. 1993; 40: 384-415. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8111991

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Evaluation and surgical treatment of high-grade isthmic dysplastic spondylolisthesis. Author(s): Lenke LG, Bridwell KH. Source: Instr Course Lect. 2003; 52: 525-32. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12690878

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Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis. Author(s): O'Sullivan PB, Phyty GD, Twomey LT, Allison GT. Source: Spine. 1997 December 15; 22(24): 2959-67. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9431633

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Ewing sarcoma presenting as spondylolisthesis. Report of a case. Author(s): Klaassen MA, Hoffman G. Source: The Journal of Bone and Joint Surgery. American Volume. 1987 September; 69(7): 1089-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3654702

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Excision of laminal pseudoarthroses in spondylolytic spondylolisthesis. A review of 13 cases. Author(s): Shiraishi T, Crock HV. Source: European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 1995; 4(1): 52-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7749908

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Facet joint remodeling in degenerative spondylolisthesis: an investigation of joint orientation and tropism. Author(s): Berlemann U, Jeszenszky DJ, Buhler DW, Harms J. Source: European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 1998; 7(5): 376-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9840470

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Factors affecting fusion rate in adult spondylolisthesis. Author(s): Kim SS, Denis F, Lonstein JE, Winter RB. Source: Spine. 1990 September; 15(9): 979-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2259992

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Factors affecting reduction in low-grade lumbosacral spondylolisthesis. Author(s): Naderi S, Manisali M, Acar F, Ozaksoy D, Mertol T, Arda MN. Source: Journal of Neurosurgery. 2003 September; 99(2 Suppl): 151-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12956456

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Failed arthrodesis of the spine for severe spondylolisthesis. Salvage by interbody arthrodesis. Author(s): Jones AA, McAfee PC, Robinson RA, Zinreich SJ, Wang H. Source: The Journal of Bone and Joint Surgery. American Volume. 1988 January; 70(1): 25-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3275674

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Failed back syndrome secondary to previous spondylolisthesis surgery. Author(s): Bradford DS. Source: Chir Organi Mov. 1994 January-March; 79(1): 109-10. English, Italian. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8076466

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Failure of a modified posterior lumbar interbody fusion technique to produce adequate pain relief in isthmic spondylolytic grade 1 spondylolisthesis patients. A prospective study of 20 patients. Author(s): Verlooy J, De Smedt K, Selosse P. Source: Spine. 1993 September 1; 18(11): 1491-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8235821

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Familial occurrence of lumbar spondylolysis and spondylolisthesis. Author(s): Haukipuro K, Keranen N, Koivisto E, Lindholm R, Norio R, Punto L. Source: Clinical Genetics. 1978 June; 13(6): 471-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=668183

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Familial spondylolisthesis of the axis vertebra. Author(s): Nordstrom RE, Lahdenranta TV, Kaitila II, Laasonen EM. Source: The Journal of Bone and Joint Surgery. British Volume. 1986 November; 68(5): 704-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3536939

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Family study of spondylolysis and spondylolisthesis. Author(s): Albanese M, Pizzutillo PD. Source: Journal of Pediatric Orthopedics. 1982; 2(5): 496-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6761366

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Fatigue fracture: the basic lesion is inthmic spondylolisthesis. Author(s): Wiltse LL, Widell EH Jr, Jackson DW. Source: The Journal of Bone and Joint Surgery. American Volume. 1975 January; 57(1): 17-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1123367

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Follow-up study of medial facetectomies and posterolateral fusion with instrumentation in unstable degenerative spondylolisthesis. Author(s): Kaneda K, Kazama H, Satoh S, Fujiya M. Source: Clinical Orthopaedics and Related Research. 1986 February; (203): 159-67. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3955976

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Foraminal encroachment syndrome in true lumbosacral spondylolisthesis: a preliminary report. Author(s): Kenitzer KW. Source: Journal of Manipulative and Physiological Therapeutics. 1988 June; 11(3): 230-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3392480

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Foraminal encroachment syndrome in true lumbosacral spondylolisthesis: a preliminary report. Author(s): Taylor DB. Source: Journal of Manipulative and Physiological Therapeutics. 1987 October; 10(5): 253-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3694062

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Functional importance of degenerative spondylolisthesis in cervical spondylotic myelopathy in the elderly. Author(s): Tani T, Kawasaki M, Taniguchi S, Ushida T. Source: Spine. 2003 June 1; 28(11): 1128-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12782980

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Functional myelograhy in spondylolisthesis. Author(s): Santi Rao D, Rodegerdts U. Source: Archives of Orthopaedic and Trauma Surgery. 1983; 101(2): 75-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6847352

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Functional outcome after partial reduction and 360 degree fusion in grade III-V spondylolisthesis in adolescent and adult patients. Author(s): Laursen M, Thomsen K, Eiskjaer SP, Hansen ES, Bunger CE. Source: Journal of Spinal Disorders. 1999 August; 12(4): 300-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10451045

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Functional outcome analysis including preoperative and postoperative SF-36 for surgically treated adult isthmic spondylolisthesis. Author(s): L'Heureux EA Jr, Perra JH, Pinto MR, Smith MD, Denis F, Lonstein JE. Source: Spine. 2003 June 15; 28(12): 1269-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12811270

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Further evidence on the acquired nature of spondylolysis and spondylolisthesis. Author(s): Beeler JW. Source: Am J Roentgenol Radium Ther Nucl Med. 1970 April; 108(4): 796-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5437284

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Global spinal motion in subjects with lumbar spondylolysis and spondylolisthesis: does the grade or type of slip affect global spinal motion? Author(s): McGregor AH, Cattermole HR, Hughes SP. Source: Spine. 2001 February 1; 26(3): 282-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11224864

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Grade 4 spondylolisthesis. Two-stage therapeutic approach of anterior vertebrectomy and anterior-posterior fusion. Author(s): Dimar JR, Hoffman G. Source: Orthop Rev. 1986 August; 15(8): 504-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3453475

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Guidelines for the management of lumbosacral spondylolisthesis associated with scoliosis. Author(s): Goldstein LA, Haake PW, Devanny JR, Chan DP. Source: Clinical Orthopaedics and Related Research. 1976 June; (117): 135-48. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1277662

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Hereditary spondylolisthesis and spina bifida. Report of a family in which the lesion is transmitted as an autosomal dominant through three generations. Author(s): Amuso SJ, Mankin HJ. Source: The Journal of Bone and Joint Surgery. American Volume. 1967 April; 49(3): 50713. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5336847

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How to stabilize a single level lesion of degenerative lumbar spondylolisthesis. Author(s): Mochida J, Suzuki K, Chiba M. Source: Clinical Orthopaedics and Related Research. 1999 November; (368): 126-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10613160

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Hypoplasia of the lumbar vertebral body simulating spondylolisthesis. Author(s): Frank DF, Miller JE. Source: Radiology. 1979 October; 133(1): 59-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=472312

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Iatrogenic lumbar spondylolisthesis: treatment by anterior fibular and iliac arthrodesis. Author(s): Heller JG, Ghanayem AJ, McAfee P, Bohlman HH. Source: Journal of Spinal Disorders. 2000 August; 13(4): 309-18. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10941890

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Iatrogenic spondylolysis leading to contralateral pedicular stress fracture and unstable spondylolisthesis: a case report. Author(s): Maurer SG, Wright KE, Bendo JA. Source: Spine. 2000 April 1; 25(7): 895-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10751305

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Imaging of spondylolysis and spondylolisthesis. Author(s): Hession PR, Butt WP. Source: European Radiology. 1996; 6(3): 284-90. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8797997

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Importance of correlating static and dynamic imaging studies in diagnosing degenerative lumbar spondylolisthesis. Author(s): Bendo JA, Ong B. Source: Am J Orthop. 2001 March; 30(3): 247-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11300136

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Importance of sagittally reformatted images in CT evaluation of spondylolisthesis. Author(s): Elster AD, Jensen KM. Source: Ajnr. American Journal of Neuroradiology. 1986 November-December; 7(6): 1102-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3098078

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In situ arthrodesis without decompression for Grade-III or IV isthmic spondylolisthesis in adults who have severe sciatica. Author(s): Peek RD, Wiltse LL, Reynolds JB, Thomas JC, Guyer DW, Widell EH. Source: The Journal of Bone and Joint Surgery. American Volume. 1989 January; 71(1): 62-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2913004

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In situ posterolateral spine arthrodesis for grades III, IV, and V spondylolisthesis in children and adolescents. Author(s): Grzegorzewski A, Kumar SJ. Source: Journal of Pediatric Orthopedics. 2000 July-August; 20(4): 506-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10912609

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Incidence of spondylolisthesis in ambulatory cerebral palsy patients. Author(s): Hennrikus WL, Rosenthal RK, Kasser JR. Source: Journal of Pediatric Orthopedics. 1993 January-February; 13(1): 37-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8416351

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Inferior and superior gluteal nerve paresis and femur neck fracture after spondylolisthesis and lysis: a case report. Author(s): de Jong PJ, van Weerden TW. Source: Journal of Neurology. 1983; 230(4): 267-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6198487

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Instrumented and noninstrumented posterolateral fusion in adult spondylolisthesis-a prospective randomized study: part 2. Author(s): Moller H, Hedlund R. Source: Spine. 2000 July 1; 25(13): 1716-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10870149

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Instrumented fusion for degenerative spondylolisthesis: is it necessary? Author(s): McLain RF. Source: Spine. 2004 January 15; 29(2): 170. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14722408

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Instrumented reduction of spondylolisthesis. Author(s): Edwards CC, Bradford DS. Source: Spine. 1994 July 1; 19(13): 1535-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7939989

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Intact arch spondylolisthesis. A review of 50 cases and description of surgical treatment. Author(s): Alexander E Jr, Kelly DL Jr, Davis CH Jr, McWhorter JM, Brown W. Source: Journal of Neurosurgery. 1985 December; 63(6): 840-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2932541

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Inter- and intratester reliability of radiographic measurements of spondylolisthesis. Author(s): Capasso G, Maffulli N, Testa V. Source: Acta Orthop Belg. 1992; 58(2): 188-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1632218

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Is there increased intervertebral mobility in isthmic adult spondylolisthesis? A matched comparative study using roentgen stereophotogrammetry. Author(s): Axelsson P, Johnsson R, Stromqvist B. Source: Spine. 2000 July 1; 25(13): 1701-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10870146

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Is there instability in spondylolisthesis? Author(s): Pearcy M, Shepherd J. Source: Spine. 1985 March; 10(2): 175-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4002042

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Isthmic lumbar spondylolisthesis with sciatica: the role of the disc. Author(s): Deutman R, Diercks RL, de Jong TE, van Woerden HH. Source: European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 1995; 4(3): 136-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7552646

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Isthmic spondylolisthesis among patients receiving disability pension under the diagnosis of chronic low back pain syndromes. Author(s): Frennered K. Source: Spine. 1994 December 15; 19(24): 2766-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7899976

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Isthmic spondylolisthesis in pycnodysostosis. Author(s): Floman Y, Gomori JM, Fast A. Source: Journal of Spinal Disorders. 1989 December; 2(4): 268-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2520085

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Isthmic spondylolisthesis in symptomatic and asymptomatic subjects, epidemiology, and natural history with special reference to disk abnormality and mode of treatment. Author(s): Osterman K, Schlenzka D, Poussa M, Seitsalo S, Virta L. Source: Clinical Orthopaedics and Related Research. 1993 December; (297): 65-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8242953

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L4-5 degenerative spondylolisthesis in monozygous twins. Author(s): Ryan MD. Source: Spine. 1994 April 15; 19(8): 985-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8009359

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L4-5 degenerative spondylolisthesis. The results of treatment by decompressive laminectomy without fusion. Author(s): Herron LD, Trippi AC. Source: Spine. 1989 May; 14(5): 534-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2727798

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L4-5 isthmic spondylolisthesis. A biomechanical analysis comparing stability in L4-5 and L5-S1 isthmic spondylolisthesis. Author(s): Grobler LJ, Novotny JE, Wilder DG, Frymoyer JW, Pope MH. Source: Spine. 1994 January 15; 19(2): 222-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8153834

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L4-L5 degenerative spondylolisthesis: indications and technique for operative management. Author(s): O'Rourke MR, Grobler LJ. Source: Iowa Orthop J. 1998; 18: 76-86. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9807712

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Long-term clinical and radiological follow-up of spondylolysis and spondylolisthesis. Author(s): Saraste H. Source: Journal of Pediatric Orthopedics. 1987 November-December; 7(6): 631-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2963019

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Long-term evaluation of adolescents treated operatively for spondylolisthesis. A comparison of in situ arthrodesis only with in situ arthrodesis and reduction followed by immobilization in a cast. Author(s): Burkus JK, Lonstein JE, Winter RB, Denis F. Source: The Journal of Bone and Joint Surgery. American Volume. 1992 June; 74(5): 693704. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1624485

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Long-term follow-up evaluation of a few patients with spondylolisthesis treated by excision of the loose lamina with decompression of the nerve roots without spinal fusion. Author(s): Gill GG. Source: Clinical Orthopaedics and Related Research. 1984 January-February; (182): 2159. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6692617

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Long-term follow-up of patients with grade-III and IV spondylolisthesis. Treatment with and without posterior fusion. Author(s): Harris IE, Weinstein SL. Source: The Journal of Bone and Joint Surgery. American Volume. 1987 September; 69(7): 960-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3654708

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Long-term functional and radiographic follow-up of surgically treated isthmic spondylolisthesis. Author(s): Bernicker JP, Kohl HW 3rd, Sahni I, Esses SI. Source: Am J Orthop. 1999 November; 28(11): 631-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10588470

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Long-term results in lumbosacral interbody fusion for spondylolisthesis. Author(s): van Rens TJ, van Horn JR. Source: Acta Orthopaedica Scandinavica. 1982 June; 53(3): 383-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6211891

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Low-grade isthmic/lytic spondylolisthesis in adults. Author(s): O'Brien MF. Source: Instr Course Lect. 2003; 52: 511-24. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12690877

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Lumbar posterolateral fusion alone or with transpedicular instrumentation in L4--L5 degenerative spondylolisthesis. Author(s): Kimura I, Shingu H, Murata M, Hashiguchi H. Source: Journal of Spinal Disorders. 2001 August; 14(4): 301-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11481551

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Lumbar spondylolisthesis. Clinical syndrome and operative experience with Cloward's technique. Author(s): Lorenz R. Source: Acta Neurochirurgica. 1982; 60(3-4): 223-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7072537

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Lumbar spondylolisthesis: a rational approach to conservative treatment. Author(s): Gramse RR, Sinaki M, Ilstrup DM. Source: Mayo Clinic Proceedings. 1980 November; 55(11): 681-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6449639

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Lumbar spondylolisthesis: retrospective comparison and three-year follow-up of two conservative treatment programs. Author(s): Sinaki M, Lutness MP, Ilstrup DM, Chu CP, Gramse RR. Source: Archives of Physical Medicine and Rehabilitation. 1989 August; 70(8): 594-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2527488

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Lumbar spondylolysis and spondylolisthesis in college football players. A prospective study. Author(s): McCarroll JR, Miller JM, Ritter MA. Source: The American Journal of Sports Medicine. 1986 September-October; 14(5): 404-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3777317

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Lumbar spondylolysis without spondylolisthesis: recognition of isolated posterior element subluxation on sagittal MR. Author(s): Ulmer JL, Mathews VP, Elster AD, King JC. Source: Ajnr. American Journal of Neuroradiology. 1995 August; 16(7): 1393-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7484621

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Lumbar spondylosis, spondylolisthesis, neurogenic claudication, and L4 radiculopathy. Author(s): Ducker TB. Source: Journal of Spinal Disorders. 1989 March; 2(1): 59-60; Discussion 61-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2562444

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Lumbar stenosis with spondylolisthesis: current concepts of surgical treatment. Author(s): Bassewitz H, Herkowitz H. Source: Clinical Orthopaedics and Related Research. 2001 March; (384): 54-60. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11249180

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Lytic spondylolisthesis in helicopter pilots. Author(s): Froom P, Froom J, Van Dyk D, Caine Y, Ribak J, Margaliot S, Floman Y. Source: Aviation, Space, and Environmental Medicine. 1984 June; 55(6): 556-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6466252

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Magnetic resonance imaging of entrapment of lumbar nerve roots in spondylolytic spondylolisthesis. Author(s): Jinkins JR, Rauch A. Source: The Journal of Bone and Joint Surgery. American Volume. 1994 November; 76(11): 1643-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7962024

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Spondylolisthesis

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Malum perforans pedis caused by spinal canal stenosis and spondylolisthesis. Author(s): Nishio K, Yamamoto O, Tsukahara J. Source: J Uoeh. 1984 June 1; 6(2): 171-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6484371

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Management of isthmic spondylolisthesis with posterolateral endoscopic foraminal decompression. Author(s): Knight M, Goswami A. Source: Spine. 2003 March 15; 28(6): 573-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12642765

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Management of severe spondylolisthesis in children and adolescents. Author(s): Boxall D, Bradford DS, Winter RB, Moe JH. Source: The Journal of Bone and Joint Surgery. American Volume. 1979 June; 61(4): 47995. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=438234

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Management of spondylolysis and spondylolisthesis in the pediatric and adolescent population. Author(s): Smith JA, Hu SS. Source: The Orthopedic Clinics of North America. 1999 July; 30(3): 487-99, Ix. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10393770

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Management of spondylolysis and spondylolisthesis. Author(s): Bradford DS. Source: Instr Course Lect. 1983; 32: 151-62. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6546063

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Measurement error of spondylolisthesis as a function of radiographic beam angle. Author(s): Wall MS, Oppenheim WL. Source: Journal of Pediatric Orthopedics. 1995 March-April; 15(2): 193-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7745092

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Mechanical factors in spondylolisthesis and spondylolysis. Author(s): Troup JD. Source: Clinical Orthopaedics and Related Research. 1976 June; (117): 59-67. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1277687

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Mechanical instability as a cause of gait disturbance in high-grade spondylolisthesis: a pre- and postoperative three-dimensional gait analysis. Author(s): Meyers LL, Dobson SR, Wiegand D, Webb JD, Mencio GA. Source: Journal of Pediatric Orthopedics. 1999 September-October; 19(5): 672-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10488874

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Microdecompression and uninstrumented single-level fusion for spinal canal stenosis with degenerative spondylolisthesis. Author(s): McCulloch JA. Source: Spine. 1998 October 15; 23(20): 2243-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9802169

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Microdecompression without fusion for radiculopathy associated with lytic spondylolisthesis. Author(s): Weiner BK, McCulloch JA. Source: Journal of Neurosurgery. 1996 October; 85(4): 582-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8814159

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Midterm follow-up of young patients fused in situ for spondylolisthesis. Author(s): Frennered AK, Danielson BI, Nachemson AL, Nordwall AB. Source: Spine. 1991 April; 16(4): 409-16. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2047914

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Minimum 10-year follow-up study of anterior lumbar interbody fusion for isthmic spondylolisthesis. Author(s): Ishihara H, Osada R, Kanamori M, Kawaguchi Y, Ohmori K, Kimura T, Matsui H, Tsuji H. Source: Journal of Spinal Disorders. 2001 April; 14(2): 91-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11285419

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Minimum 5-year results of degenerative spondylolisthesis treated with decompression and instrumented posterior fusion. Author(s): Booth KC, Bridwell KH, Eisenberg BA, Baldus CR, Lenke LG. Source: Spine. 1999 August 15; 24(16): 1721-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10472107

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Modified repair of a defect in spondylolysis or minimal spondylolisthesis by pedicle screw, segmental wire fixation, and bone grafting. Author(s): Salib RM, Pettine KA. Source: Spine. 1993 March 15; 18(4): 440-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8470004

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Spondylolisthesis

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Modified sacrospinalis muscle pedicle bone graft for fusion of isthmic spondylolisthesis. Author(s): Adam FF. Source: International Orthopaedics. 2001; 25(5): 326-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11794270

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Multiplanar CT in the evaluation of degenerative spondylolisthesis. A review of 150 cases. Author(s): Rothman SL, Glenn WV Jr, Kerber CW. Source: Comput Radiol. 1985 July-August; 9(4): 223-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4064628

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Myelography in lumbar spondylolisthesis. Author(s): Laasonen EM, Ehrstrom J. Source: Acta Radiol Diagn (Stockh). 1978; 19(6): 889-96. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=735841

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Myelography in severe lumbosacral spondylolisthesis. Author(s): Buirski G, McCall IW, O'Brien JP. Source: The British Journal of Radiology. 1984 December; 57(684): 1067-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6509285

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Natural history of degenerative spondylolisthesis. Pathogenesis and natural course of the slippage. Author(s): Matsunaga S, Sakou T, Morizono Y, Masuda A, Demirtas AM. Source: Spine. 1990 November; 15(11): 1204-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2267617

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Natural history of symptomatic isthmic low-grade spondylolisthesis in children and adolescents: a seven-year follow-up study. Author(s): Frennered AK, Danielson BI, Nachemson AL. Source: Journal of Pediatric Orthopedics. 1991 March-April; 11(2): 209-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2010523

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Need for multiple diagnosis in the presence of spondylolisthesis. Author(s): Ventura JM, Justice BD. Source: Journal of Manipulative and Physiological Therapeutics. 1988 February; 11(1): 41-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2965200

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Nerve root ablation in association with degenerative spondylolisthesis. A case report. Author(s): McLaren CA, Scott JH. Source: Spine. 1988 January; 13(1): 133-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3381128

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Nerve root compression in spondylolysis and spondylolisthesis. Author(s): Edelson JG, Nathan H. Source: The Journal of Bone and Joint Surgery. British Volume. 1986 August; 68(4): 5969. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3733837

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Neural arch dysplasia of the sixth cervical vertebra. "Congenital cervical spondylolisthesis". Author(s): Moseley I. Source: The British Journal of Radiology. 1976 January; 49(577): 81-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1276580

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Neurogenic intermittent claudication in association with spondylolisthesis. Author(s): Fredriksen A, Mangschau A. Source: Acta Neurologica Scandinavica. 1979 December; 60(6): 385-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=549445

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Neuropathic lumbar spondylolisthesis--a rare trigger for posture induced autonomic dysreflexia. Author(s): Thumbikat P, Ravichandran G, McClelland MR. Source: Spinal Cord : the Official Journal of the International Medical Society of Paraplegia. 2001 November; 39(11): 564-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11641804

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Night pain associated with diminished cardiopulmonary compliance. A concomitant of lumbar spinal stenosis and degenerative spondylolisthesis. Author(s): LaBan MM, Wesolowski DP. Source: American Journal of Physical Medicine & Rehabilitation / Association of Academic Physiatrists. 1988 August; 67(4): 155-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3401361

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No difference in clinical outcome after posterolateral lumbar fusion between patients with isthmic spondylolisthesis and those with degenerative disc disease using pedicle screw instrumentation: a comparative study of 112 patients with 4 years of follow-up. Author(s): Gehrchen PM, Dahl B, Katonis P, Blyme P, Tondevold E, Kiaer T. Source: European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 2002 October; 11(5): 423-7. Epub 2002 April 18. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12384748

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Nonoperative treatment for painful adolescent spondylolysis or spondylolisthesis. Author(s): Pizzutillo PD, Hummer CD 3rd. Source: Journal of Pediatric Orthopedics. 1989 September-October; 9(5): 538-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2529267

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Nonsurgically managed patients with degenerative spondylolisthesis: a 10- to 18-year follow-up study. Author(s): Matsunaga S, Ijiri K, Hayashi K. Source: Journal of Neurosurgery. 2000 October; 93(2 Suppl): 194-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11012048

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Nursing care study: an 11-year-old girl with spondylolisthesis. Author(s): Briggs D, Evans A. Source: Nurs Times. 1982 March 24-30; 78(12): 483-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6918951

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Occupational spondylolysis and spondylolisthesis. Author(s): Jakab G. Source: Baillieres Clin Rheumatol. 1989 April; 3(1): 89-98. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2661033

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One stage reduction and fusion for spondylolisthesis. Author(s): Schollner D. Source: International Orthopaedics. 1990; 14(2): 145-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2373561

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One versus two BAK fusion cages in posterior lumbar interbody fusion to L4-L5 degenerative spondylolisthesis: a randomized, controlled prospective study in 25 patients with minimum two-year follow-up. Author(s): Zhao J, Wang X, Hou T, He S. Source: Spine. 2002 December 15; 27(24): 2753-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12486342

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One-stage decompression and posterolateral and interbody fusion for severe spondylolisthesis. An analysis of 14 patients. Author(s): Roca J, Ubierna MT, Caceres E, Iborra M. Source: Spine. 1999 April 1; 24(7): 709-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10209803

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One-stage posterior decompression-stabilization and trans-sacral interbody fusion after partial reduction for severe L5-S1 spondylolisthesis. Author(s): Bartolozzi P, Sandri A, Cassini M, Ricci M. Source: Spine. 2003 June 1; 28(11): 1135-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12782981

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Oophorectomy predisposes to degenerative spondylolisthesis. Author(s): Imada K, Matsui H, Tsuji H. Source: The Journal of Bone and Joint Surgery. British Volume. 1995 January; 77(1): 12630. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7822369

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Operative and conservative treatment of moderate spondylolisthesis in young patients. Author(s): Seitsalo S. Source: The Journal of Bone and Joint Surgery. British Volume. 1990 September; 72(5): 908-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2211782

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Operative treatment of spondylolisthesis in children and adolescents with tight hamstrings syndrome. Author(s): Sevastikoglou JA, Spangfort E, Aaro S. Source: Clinical Orthopaedics and Related Research. 1980 March-April; (147): 192-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7371294

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Operative treatment of spondylolisthesis in young patients. Author(s): Laurent LE, Osterman K. Source: Clinical Orthopaedics and Related Research. 1976 June; (117): 85-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1277689

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Orientation and tropism of lumbar facet joints in degenerative spondylolisthesis. Author(s): Dai LY. Source: International Orthopaedics. 2001; 25(1): 40-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11374266

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Osteoporotic spondylolisthesis: a case report. Author(s): Tabrizi P, Bouchard JA. Source: Spine. 2001 July 1; 26(13): 1482-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11458155

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Outcome analysis for adults with spondylolisthesis treated with posterolateral fusion and transpedicular screw fixation. Author(s): Schnee CL, Freese A, Ansell LV. Source: Journal of Neurosurgery. 1997 January; 86(1): 56-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8988082

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Outcome of one-level posterior lumbar interbody fusion for spondylolisthesis and postoperative intervertebral disc degeneration adjacent to the fusion. Author(s): Miyakoshi N, Abe E, Shimada Y, Okuyama K, Suzuki T, Sato K. Source: Spine. 2000 July 15; 25(14): 1837-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10888954

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Outcome of posterior lumbar interbody fusion versus posterolateral fusion for spondylolytic spondylolisthesis. Author(s): Madan S, Boeree NR. Source: Spine. 2002 July 15; 27(14): 1536-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12131714

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Painful spondylolisthesis in a two-year-old child. Author(s): Lucey SD, Gross R. Source: Journal of Pediatric Orthopedics. 1995 March-April; 15(2): 199-201. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7745093

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Paradoxical motion in spondylolisthesis due to two-segment instability. Author(s): Ehara S, Shimamura T. Source: Archives of Orthopaedic and Trauma Surgery. 1997; 116(6-7): 435-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9266060

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Pathoanatomic mechanisms of degenerative spondylolisthesis. A radiographic study. Author(s): Nagaosa Y, Kikuchi S, Hasue M, Sato S. Source: Spine. 1998 July 1; 23(13): 1447-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9670395

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Pathogenesis of sports-related spondylolisthesis in adolescents. Radiographic and magnetic resonance imaging study. Author(s): Ikata T, Miyake R, Katoh S, Morita T, Murase M. Source: The American Journal of Sports Medicine. 1996 January-February; 24(1): 94-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8638762

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Patient outcomes after decompression and instrumented posterior spinal fusion for degenerative spondylolisthesis. Author(s): Nork SE, Hu SS, Workman KL, Glazer PA, Bradford DS. Source: Spine. 1999 March 15; 24(6): 561-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10101820

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Pedicle screw fixation for isthmic spondylolisthesis: does posterior lumbar interbody fusion improve outcome over posterolateral fusion? Author(s): La Rosa G, Conti A, Cacciola F, Cardali S, La Torre D, Gambadauro NM, Tomasello F. Source: Journal of Neurosurgery. 2003 September; 99(2 Suppl): 143-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12956455

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Pelvic lordosis and alignment in spondylolisthesis. Author(s): Jackson RP, Phipps T, Hales C, Surber J. Source: Spine. 2003 January 15; 28(2): 151-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12544932

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Posterior interbody arthrodesis with a fibular strut graft in spondylolisthesis. Author(s): Esses SI, Natout N, Kip P. Source: The Journal of Bone and Joint Surgery. American Volume. 1995 February; 77(2): 172-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7844122

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Posterior interbody fusion using laminectomy bone and transpedicular screw fixation in the treatment of lumbar spondylolisthesis. Author(s): Csecsei GI, Klekner AP, Dobai J, Lajgut A, Sikula J. Source: Surgical Neurology. 2000 January; 53(1): 2-6; Discussion 6-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10697227

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Posterior pedicular screw instrumentation and anterior interbody fusion in adult lumbar spondylolysis or grade I spondylolisthesis with segmental instability. Author(s): Wang JM, Kim DJ, Yun YH. Source: Journal of Spinal Disorders. 1996 April; 9(2): 83-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8793773

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Posterior reduction and anterior lumbar interbody fusion in symptomatic low-grade adult isthmic spondylolisthesis: short-term radiological and functional outcome. Author(s): Spruit M, Pavlov PW, Leitao J, De Kleuver M, Anderson PG, Den Boer F. Source: European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 2002 October; 11(5): 428-33; Discussion 434. Epub 2002 May 14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12384749

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Posterior stabilization in L5-S1 isthmic spondylolisthesis with paralaminar screw fixation: anatomical and clinical results. Author(s): Jeanneret B, Miclau T, Kuster M, Neuer W, Magerl F. Source: Journal of Spinal Disorders. 1996 June; 9(3): 223-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8854278

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Posterolateral fusion for isthmic spondylolisthesis in adults: analysis of fusion rate and clinical results. Author(s): Deguchi M, Rapoff AJ, Zdeblick TA. Source: Journal of Spinal Disorders. 1998 December; 11(6): 459-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9884288

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Posterolateral fusion for radicular pain in isthmic spondylolisthesis. Author(s): de Loubresse CG, Bon T, Deburge A, Lassale B, Benoit M. Source: Clinical Orthopaedics and Related Research. 1996 February; (323): 194-201. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8625579

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Posterolateral lumbar fusion for degenerative spondylolisthesis: experiences of a modified technique without instrumentation. Author(s): Unnanantana A. Source: J Med Assoc Thai. 1997 September; 80(9): 570-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9347669

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Predictors of outcome in patients with chronic back pain and low-grade spondylolisthesis. Author(s): Vaccaro AR, Ring D, Scuderi G, Cohen DS, Garfin SR. Source: Spine. 1997 September 1; 22(17): 2030-4; Discussion 2035. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9306535

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Predisposing factors in degenerative spondylolisthesis. A radiographic and CT study. Author(s): Cinotti G, Postacchini F, Fassari F, Urso S. Source: International Orthopaedics. 1997; 21(5): 337-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9476166

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Preoperative reduction of spondylolisthesis. Author(s): Marchetti PG, Bartolozzi P, Binazzi R, Vaccari V, Girolami M, Impallomeni C, Morici F, Bevoni R. Source: Chir Organi Mov. 2002 October-December; 87(4): 203-15. English, Italian. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12847789

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Progression of lumbosacral isthmic spondylolisthesis in adults. Author(s): Floman Y. Source: Spine. 2000 February 1; 25(3): 342-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10703107

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Prospective study of surgical treatment of degenerative spondylolisthesis: comparison between decompression alone and decompression with graf system stabilization. Author(s): Konno S, Kikuchi S. Source: Spine. 2000 June 15; 25(12): 1533-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10851102

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Quantitative changes in spinal canal dimensions using interbody distraction for spondylolisthesis. Author(s): Vamvanij V, Ferrara LA, Hai Y, Zhao J, Kolata R, Yuan HA. Source: Spine. 2001 February 1; 26(3): E13-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11224873

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Radiographic correlations in adult symptomatic spondylolisthesis: a long-term follow-up study. Author(s): Virta L, Osterman K. Source: Journal of Spinal Disorders. 1994 February; 7(1): 41-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8186588

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Radiographic evaluation of instability in spondylolisthesis. Author(s): Wood KB, Popp CA, Transfeldt EE, Geissele AE. Source: Spine. 1994 August 1; 19(15): 1697-703. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7973963

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Radiographic markers in spondyloptosis: implications for spondylolisthesis progression. Author(s): Curylo LJ, Edwards C, DeWald RW. Source: Spine. 2002 September 15; 27(18): 2021-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12634562

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Radiologic assessment of lumbar intervertebral instability and degenerative spondylolisthesis. Author(s): Nizard RS, Wybier M, Laredo JD. Source: Radiologic Clinics of North America. 2001 January; 39(1): 55-71, V-Vi. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11221506

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Radiology rounds. Bilateral spondylolysis at L5 with associated spondylolisthesis. Author(s): McLennan MK. Source: Can Fam Physician. 1999 June; 45: 1457, 1465-6, 1468 Passim. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10386209

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Re: Surgery versus conservative medical and adult isthmic spondylolisthesis (Spine 2000; 25: 1711-15). Author(s): Mooney V. Source: Spine. 2001 March 1; 26(5): 594-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11242393

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Reduction and stabilization without laminectomy for unstable degenerative spondylolisthesis: a preliminary report. Author(s): Benini A, Plotz G. Source: Neurosurgery. 1995 October; 37(4): 843-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8559318

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Reduction and stabilization without laminectomy for unstable degenerative spondylolisthesis: a preliminary report. Author(s): Morgan H. Source: Neurosurgery. 1995 April; 36(4): 874. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7596524

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Reduction and stabilization without laminectomy for unstable degenerative spondylolisthesis: a preliminary report. Author(s): Lee TC. Source: Neurosurgery. 1994 December; 35(6): 1072-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7885551

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Reduction of high-grade spondylolisthesis using Edwards instrumentation. Author(s): Hu SS, Bradford DS, Transfeldt EE, Cohen M. Source: Spine. 1996 February 1; 21(3): 367-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8742214

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Reduction of lumbar spondylolisthesis using a CDI pedicle screw system. Author(s): Aota Y, Kumano K, Hirabayashi S, Ogawa Y. Source: Archives of Orthopaedic and Trauma Surgery. 1995; 114(4): 188-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7662471

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Reduction of severe lumbosacral spondylolisthesis. A report of 22 cases with a tenyear follow-up period. Author(s): O'Brien JP, Mehdian H, Jaffray D. Source: Clinical Orthopaedics and Related Research. 1994 March; (300): 64-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8131357

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Reduction-fixation spinal system in spondylolisthesis. Author(s): Niu CC, Chen WJ, Chen LH, Shih CH. Source: Am J Orthop. 1996 June; 25(6): 418-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8798984

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Reliability of radiographical measurements of spondylolisthesis and extensionflexion radiographs of the lumbar spine. Author(s): Tallroth K, Ylikoski M, Landtman M, Santavirta S. Source: European Journal of Radiology. 1994 August; 18(3): 227-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7957297

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Remodelling of the sacrum in high-grade spondylolisthesis: a report of two cases. Author(s): van Ooij A, Weijers R, van Rhijn L. Source: European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 2003 June; 12(3): 332-8. Epub 2003 March 21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12800009

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Results of a trial of anterior or circumferential lumbar fusion in the treatment of severe isthmic spondylolisthesis in young patients. Author(s): Tiusanen H, Schlenzka D, Seitsalo S, Poussa M, Osterman K. Source: Journal of Pediatric Orthopaedics. Part B / European Paediatric Orthopaedic Society, Pediatric Orthopaedic Society of North America. 1996 Summer; 5(3): 190-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8866285

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Results of degenerative spondylolisthesis treated with posterior decompression alone via a new surgical approach. Author(s): Kinoshita T, Ohki I, Roth KR, Amano K, Moriya H. Source: Journal of Neurosurgery. 2001 July; 95(1 Suppl): 11-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11453409

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Results of in situ fusion for isthmic spondylolisthesis. Author(s): Lenke LG, Bridwell KH, Bullis D, Betz RR, Baldus C, Schoenecker PL. Source: Journal of Spinal Disorders. 1992 December; 5(4): 433-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1490041

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Results of screw osteosynthesis in spondylolysis and low-grade spondylolisthesis. Author(s): Winter M, Jani L. Source: Archives of Orthopaedic and Trauma Surgery. 1989; 108(2): 96-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2923536

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Results of surgical treatment for lumbar canal stenosis due to degenerative spondylolisthesis: enlargement of the lumbar spinal canal. Author(s): Ito Y, Oda H, Taguchi T, Inoue H, Kawai S. Source: Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association. 2003; 8(5): 648-56. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14557930

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Sacrospinalis muscle-pedicle bone graft in posterolateral fusion for spondylolisthesis. Author(s): Baksi DP. Source: International Orthopaedics. 1998; 22(4): 234-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9795810

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Sagittal plane configuration of the sacrum in spondylolisthesis. Author(s): Antoniades SB, Hammerberg KW, DeWald RL. Source: Spine. 2000 May 1; 25(9): 1085-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10788852

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Scoliosis associated with lumbar spondylolisthesis: a case presentation and review of the literature. Author(s): Pneumaticos SG, Esses SI. Source: The Spine Journal : Official Journal of the North American Spine Society. 2003 July-August; 3(4): 321-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14589194

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Single-level posterolateral arthrodesis, with or without posterior decompression, for the treatment of isthmic spondylolisthesis in adults. A prospective, randomized study. Author(s): Carragee EJ. Source: The Journal of Bone and Joint Surgery. American Volume. 1997 August; 79(8): 1175-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9278077

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Spinal fusion and pedicle screw instrumentation in the treatment of spondylolisthesis over the age of 60. Author(s): Wang PJ, Chen WJ, Chen LH, Niu CC. Source: Changgeng Yi Xue Za Zhi. 1998 December; 21(4): 436-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10074730

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Spondylolisthesis in children and adolescents. Author(s): Nance DK, Hickey M. Source: Orthopaedic Nursing / National Association of Orthopaedic Nurses. 1999 January-February; 18(1): 21-7; Quiz 28-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10223001

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Spondylolisthesis in children. Cause, natural history, and management. Author(s): Lonstein JE. Source: Spine. 1999 December 15; 24(24): 2640-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10635527

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Spondylolisthesis in the elite football player: an epidemiologic study in the NCAA and NFL. Author(s): Shaffer B, Wiesel S, Lauerman W. Source: Journal of Spinal Disorders. 1997 October; 10(5): 365-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9355050

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Spondylolisthesis with sciatica. Magnetic resonance findings and chemonucleolysis. Author(s): Rijk PC, Deutman R, de Jong TE, van Woerden HH. Source: Clinical Orthopaedics and Related Research. 1996 May; (326): 146-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8620635

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Spondylolysis and spondylolisthesis in the athlete. Author(s): Lundin DA, Wiseman DB, Shaffrey CI. Source: Clin Neurosurg. 2002; 49: 528-47. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12506568

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Spondylolysis and spondylolisthesis in the child and adolescent athlete. Author(s): Herman MJ, Pizzutillo PD, Cavalier R. Source: The Orthopedic Clinics of North America. 2003 July; 34(3): 461-7, Vii. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12974495

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Spontaneous fusion of isthmic spondylolisthesis after discitis: a case report. Author(s): Nagashima H, Morio Y, Nishi T, Hagino H, Teshima R. Source: Clinical Orthopaedics and Related Research. 2002 October; (403): 104-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12360015

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Surgery versus conservative management in adult isthmic spondylolisthesis--a prospective randomized study: part 1. Author(s): Moller H, Hedlund R. Source: Spine. 2000 July 1; 25(13): 1711-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10870148

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Surgical management of isthmic spondylolisthesis with radicular pain. Author(s): Adam FF. Source: International Orthopaedics. 2003; 27(5): 311-4. Epub 2003 July 03. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12844236

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Surgical management of low-grade lytic spondylolisthesis with C-D instrumentation in adult patients. Author(s): Nooraie H, Ensafdaran A, Arasteh MM. Source: Archives of Orthopaedic and Trauma Surgery. 1999; 119(5-6): 337-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10447635

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Surgical management of severe spondylolisthesis in children and adolescents. Anterior fusion in situ versus anterior spondylodesis with posterior transpedicular instrumentation and reduction. Author(s): Muschik M, Zippel H, Perka C. Source: Spine. 1997 September 1; 22(17): 2036-42; Discussion 2043. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9306536

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Surgical treatment of lumbar spondylolisthesis. Author(s): Detwiler PW, Porter RW, Han PP, Karahalios DG, Masferrer R, Sonntag VK. Source: Adv Tech Stand Neurosurg. 2000; 26: 331-46. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10997202

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Surgical treatment of spondylolisthesis with SOCON instrumentation. Author(s): Jin J, Jianxiong S, Guixing Q, Hong Z, Xisheng W, Yipeng W. Source: Chinese Medical Sciences Journal = Chung-Kuo I Hsueh K'o Hsueh Tsa Chih / Chinese Academy of Medical Sciences. 2000 June; 15(2): 111-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12901636

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Survivorship analysis of DKS instrumentation in the treatment of spondylolisthesis. Author(s): Chen WJ, Niu CC, Chen LH, Shih CH. Source: Clinical Orthopaedics and Related Research. 1997 June; (339): 113-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9186209

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Symptoms, signs, and functional disability in adult spondylolisthesis. Author(s): Moller H, Sundin A, Hedlund R. Source: Spine. 2000 March 15; 25(6): 683-9; Discussion 690. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10752099

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The argument for instrumented decompressive posterolateral fusion for patients with degenerative spondylolisthesis and spinal stenosis. Author(s): Fischgrund JS. Source: Spine. 2004 January 15; 29(2): 173-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14722410

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The argument for noninstrumented posterolateral fusion for patients with spinal stenosis and degenerative spondylolisthesis. Author(s): Phillips FM. Source: Spine. 2004 January 15; 29(2): 170-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14722409

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The distraction reduction fixation system and its application in spondylolisthesis. Author(s): Wang Y, Ye Q, Qiu G, Lin J, Zhang J. Source: Chinese Medical Sciences Journal = Chung-Kuo I Hsueh K'o Hsueh Tsa Chih / Chinese Academy of Medical Sciences. 2001 June; 16(2): 93-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12901497

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The lumbar zygapophyseal (facet) joints: a role in the pathogenesis of spinal pain syndromes and degenerative spondylolisthesis. Author(s): Berven S, Tay BB, Colman W, Hu SS. Source: Seminars in Neurology. 2002 June; 22(2): 187-96. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12524564

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The natural history of spondylolysis and spondylolisthesis: 45-year follow-up evaluation. Author(s): Beutler WJ, Fredrickson BE, Murtland A, Sweeney CA, Grant WD, Baker D. Source: Spine. 2003 May 15; 28(10): 1027-35; Discussion 1035. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12768144

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The prevalence of cervical spondylolisthesis. Author(s): Kopacz KJ, Connolly PJ. Source: Orthopedics. 1999 July; 22(7): 677-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10418863

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The role of lumbar lordosis, vertebral end-plate inclination, disc height, and facet orientation in degenerative spondylolisthesis. Author(s): Berlemann U, Jeszenszky DJ, Buhler DW, Harms J. Source: Journal of Spinal Disorders. 1999 February; 12(1): 68-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10078953

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The role of transitional vertebrae in spondylolysis and spondylolytic spondylolisthesis. Author(s): Kim NH, Suk KS. Source: Bull Hosp Jt Dis. 1997; 56(3): 161-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9361917

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The sagittal pelvic tilt index as a criterion in the evaluation of spondylolisthesis. Preliminary observations. Author(s): Schwab FJ, Farcy JP, Roye DP Jr. Source: Spine. 1997 July 15; 22(14): 1661-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9253103

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The surgical treatment of spondylolisthesis with transpedicular stabilization: a review of 25 cases. Author(s): Lisai P, Rinonapoli G, Doria C, Manunta A, Crissantu L, De Santis E. Source: Chir Organi Mov. 1998 October-December; 83(4): 369-74. English, Italian. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10369016

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Threaded fusion cage for lumbar spondylolisthesis. Author(s): Mizuno J, Nakagawa H. Source: Neurol Med Chir (Tokyo). 1998 March; 38(3): 155-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9597858

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Transdiscal L5-S1 screws for the fixation of isthmic spondylolisthesis: a biomechanical evaluation. Author(s): Minamide A, Akamaru T, Yoon ST, Tamaki T, Rhee JM, Hutton WC. Source: Journal of Spinal Disorders & Techniques. 2003 April; 16(2): 144-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12679668

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Transvertebral interbody cage and pedicle screw fixation for high-grade spondylolisthesis. Case report. Author(s): Bozkus H, Dickman CA. Source: Journal of Neurosurgery. 2004 January; 100(1 Suppl): 62-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14748576

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Transvertebral pedicle fixation in severe grade spondylolisthesis. Report of three cases. Author(s): Chell J, Quinnell RC. Source: Journal of Neurosurgery. 2001 July; 95(1 Suppl): 105-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11453407

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Traumatic L5-S1 spondylolisthesis. Author(s): Hodges SD, Shuster J, Asher MA, McClarty SJ. Source: Southern Medical Journal. 1999 March; 92(3): 316-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10094275

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Traumatic L5-S1 spondylolisthesis: report of three cases and a review of the literature. Author(s): Fabris D, Costantini S, Nena U, Lo Scalzo V. Source: European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 1999; 8(4): 290-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10483831

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Traumatic spondylolisthesis of the axis: analysis of management. Author(s): Barros TE, Bohlman HH, Capen DA, Cotler J, Dons K, Biering-Sorensen F, Marchesi DG, Zigler JE. Source: Spinal Cord : the Official Journal of the International Medical Society of Paraplegia. 1999 March; 37(3): 166-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10213325

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Traumatic spondylolisthesis of the axis: treatment rationale based on the stability of the different fracture types. Author(s): Muller EJ, Wick M, Muhr G. Source: European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 2000 April; 9(2): 123-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10823428

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Traumatic spondylolisthesis of the lumbosacral spine with multiple fractures of the posterior elements. Author(s): Miyamoto H, Sumi M, Kataoka O, Doita M, Kurosaka M, Yoshiya S. Source: The Journal of Bone and Joint Surgery. British Volume. 2004 January; 86(1): 1158. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14765878

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Treatment of lumbar spondylolisthesis by Socon internal fixator: report of 18 cases. Author(s): Jin AM, Cao H, Yao WT, Tong BH. Source: Di Yi June Yi Da Xue Xue Bao. 2002 March; 22(3): 230-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12390772

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Ultrastructural changes in paravertebral muscles associated with degenerative spondylolisthesis. Author(s): Ramsbacher J, Theallier-Janko A, Stoltenburg-Didinger G, Brock M. Source: Spine. 2001 October 15; 26(20): 2180-4; Discussion 2185. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11598503

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Unstable degenerative spondylolisthesis of the cervical spine. Author(s): Deburge A, Mazda K, Guigui P. Source: The Journal of Bone and Joint Surgery. British Volume. 1995 January; 77(1): 1225. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7822368

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Vacuum facet phenomenon: a computed tomographic sign of degenerative spondylolisthesis. Author(s): Lefkowitz DM, Quencer RM. Source: Radiology. 1982 August; 144(3): 562. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7100472

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Vertebral contour in spondylolisthesis. Author(s): Slim GP. Source: The British Journal of Radiology. 1973 April; 46(544): 250-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4720737

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Vertebral motion in spondylolisthesis. Author(s): Olsson TH, Selvik G, Willner S. Source: Acta Radiol Diagn (Stockh). 1976 November; 17(6): 861-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1016510

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Vertebral slip in lumbar spondylolysis and spondylolisthesis. Long-term follow-up of 22 adult patients. Author(s): Ohmori K, Ishida Y, Takatsu T, Inoue H, Suzuki K. Source: The Journal of Bone and Joint Surgery. British Volume. 1995 September; 77(5): 771-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7559708

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CHAPTER 2. NUTRITION AND SPONDYLOLISTHESIS Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and spondylolisthesis.

Finding Nutrition Studies on Spondylolisthesis The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.4 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “spondylolisthesis” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

4

Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.

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The following information is typical of that found when using the “Full IBIDS Database” to search for “spondylolisthesis” (or a synonym): •

Adult isthmic spondylolisthesis. Author(s): Department of Orthopedic Surgery, Thomas Jefferson University Hospital, Philadelphia, Pa, USA. Source: Vaccaro, A R Martyak, G G Madigan, L Orthopedics. 2001 December; 24(12): 1172-7; quiz 1178-9 0147-7447

Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •

healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0

•

The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov

•

The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov

•

The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/

•

The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/

•

Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/

•

Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/

•

Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/

Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html

•

Google: http://directory.google.com/Top/Health/Nutrition/

•

Healthnotes: http://www.healthnotes.com/

•

Open Directory Project: http://dmoz.org/Health/Nutrition/

•

Yahoo.com: http://dir.yahoo.com/Health/Nutrition/

Nutrition

•

WebMDHealth: http://my.webmd.com/nutrition

•

WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

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CHAPTER 3. CLINICAL TRIALS AND SPONDYLOLISTHESIS Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning spondylolisthesis.

Recent Trials on Spondylolisthesis The following is a list of recent trials dedicated to spondylolisthesis.5 Further information on a trial is available at the Web site indicated. •

Spine Patient Outcomes Research Trial (SPORT): Degenerative Spondylolisthesis with Spinal Stenosis Condition(s): Spondylolisthesis; Spinal Stenosis; Low Back Pain Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); National Institute for Occupational Safety and Health (NIOSH/CDC); Office of Research on Women's Health (ORWH) Purpose - Excerpt: This study tests the effectiveness of different treatments for the three most commonly diagnosed conditions of the lower backbone (lumbar spine). The purpose is to learn which of two commonly prescribed treatments (surgery and nonsurgical therapy) works better for specific types of low back pain. In this part of the study, we will treat patients with spinal stenosis (a narrowing of spaces in the backbone that results in pressure on the spinal cord and/or nerve roots) caused by degenerative spondylolisthesis (a condition in which one vertebra, or spinal bone, slips forward on another) with either surgery or nonsurgical methods. This study does not cover the cost of treatment. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000409

5

These are listed at www.ClinicalTrials.gov.

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Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions. The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “spondylolisthesis” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials: •

For clinical studies at the Warren Grant Magnuson Clinical Center located in Bethesda, Maryland, visit their Web site: http://clinicalstudies.info.nih.gov/

•

For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html

•

For cancer trials, visit the National Cancer Institute: http://cancertrials.nci.nih.gov/

•

For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm

•

For heart, lung and blood trials, visit the Web page of the National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/studies/index.htm

•

For trials on aging, visit and search the Web site of the National Institute on Aging: http://www.grc.nia.nih.gov/studies/index.htm

•

For rare diseases, visit and search the Web site sponsored by the Office of Rare Diseases: http://ord.aspensys.com/asp/resources/rsch_trials.asp

•

For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm

•

For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/

•

For trials on arthritis, musculoskeletal and skin diseases, visit newly revised site of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health: http://www.niams.nih.gov/hi/studies/index.htm

•

For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm

•

For trials on diseases of the digestive system and kidneys, and diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/patient/patient.htm

•

For drug abuse trials, visit and search the Web site sponsored by the National Institute on Drug Abuse: http://www.nida.nih.gov/CTN/Index.htm

Clinical Trials 57

•

For trials on mental disorders, visit and search the Web site of the National Institute of Mental Health: http://www.nimh.nih.gov/studies/index.cfm

•

For trials on neurological disorders and stroke, visit and search the Web site sponsored by the National Institute of Neurological Disorders and Stroke of the NIH: http://www.ninds.nih.gov/funding/funding_opportunities.htm#Clinical_Trials

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CHAPTER 4. PATENTS ON SPONDYLOLISTHESIS Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.6 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “spondylolisthesis” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on spondylolisthesis, we have not necessarily excluded non-medical patents in this bibliography.

Patents on Spondylolisthesis By performing a patent search focusing on spondylolisthesis, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. 6Adapted

from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.

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The following is an example of the type of information that you can expect to obtain from a patent search on spondylolisthesis: •

Apparatus and method for the manipulation of the spine and sacrum in the treatment of spondylolisthesis Inventor(s): Rogozinski; Chaim (3223 Front Rd., Jacksonville, FL 32217) Assignee(s): None Reported Patent Number: 6,565,568 Date filed: September 28, 2000 Abstract: An apparatus and a method for performing spondylolisthesis reduction utilizing spinal link implants, the apparatus comprising a jack which is temporarily affixed to the spinal links, where the jack is constructed to provide leverage or fulcrum points such that the vertebrae or sacrum can be moved as required for, proper realignment and to position adjacent link members for connection. The jack comprises a pair of outrigger members connected to a levering member such that each is free to pivot, whereby the relative angle between the members may be altered by movement of the levering member, which is provided with at least one handle to be gripped by the surgeon. Optionally, an outrigger stabilizer member is also provided. The ends of the outrigger members are provided with connector means for temporarily securing the outriggers to the linking members in a secure manner such that any manipulation of the outrigger members is transferred to the spinal link members and thus to the vertebra or sacrum to which they are affixed. With the sacrum and vertebrae properly aligned and positioned, the spinal links are joined to form a rigid structure and the jack is removed. Excerpt(s): This invention relates generally to the field of medical devices and methods of treatment of spondylolisthesis, and more particularly to the field of such devices and methods for manipulation of adjacent vertebrae or of the lower vertebrae and the sacrum (which in humans is formed of fused vertebrae), whereby the adjacent vertebrae or the vertebrae and sacrum are properly aligned and positioned such that fixation structures can be utilized to secure the adjacent vertebrae or the vertebrae and sacrum in the proper relation. Even more particularly, the invention relates to a mechanical apparatus or jack which can be temporarily attached to spinal implants permanently affixed to both the vertebrae and the sacrum, whereby the surgeon performs the spondylolisthesis reduction by manipulating the jack to properly position the vertebrae and sacrum and then securing the sacrum spinal implant to the vertebral, spinal implant in rigid manner. The invention herein functions with and incorporates portions of the apparatus and method disclosed in my U.S. Pat. No. 6,017,343, issued Jan. 25, 2000, and entitled Apparatus, Method and System for the Treatment of Spinal Conditions and Fixation of Pelvis and Long Bones, the disclosure of which is herein incorporated by reference. The invention will also function with other types of spinal implants and mechanical fixation devices used to create a construct which will secure the adjacent pairs of vertebrae or the sacrum and vertebrae in a fixed, rigid relationship, such as plates or rods. The lumbar vertebrae comprise the five vertebrae positioned below the dorsal vertebrae, and are customarily designated L1 through L5, with L1 being adjacent the lowermost or twelfth dorsal vertebra and L5 being adjacent the sacrum. The sacrum is a large, curved, triangular bone having a wide base which articulates from the L5 vertebra. The anterior surface of the sacrum is generally concave, curving in a pronounced manner from above downward and slightly from side to side. Spondylolisthesis is a condition where adjacent vertebrae, most usually the sacrum and the lower or lumbar vertebrae, are not properly aligned or connected, such that adjacent

Patents 61

vertebrae are displaced or the lumbar vertebrae are displaced anteriorly from the upper base of the sacrum. For purposes of this disclosure, the apparatus and method shall be described primarily with reference to spondylolisthesis occurring between the L5 vertebra and the sacrum, but it is to be expressly understood that the apparatus and method are suitable for manipulation and treatment of any adjacent vertebrae. In a spondylolisthesis reduction, the surgeon properly repositions the vertebrae and sacrum, and then permanently joins the vertebrae and sacrum using mechanical fixation structures. The reduction may require manipulation of the vertebrae and the sacrum in one or more directions, i.e., translation in the anterior/ventral or posterior/dorsal direction, compression or distraction in the longitudinal direction of the vertebral axis, and rotation about the vertebral axis, as well as pivotal flexion of the sacrum in the ventral direction or pivotal extension of the sacrum in the dorsal direction. Web site: http://www.delphion.com/details?pn=US06565568__ •

Method and apparatus for spondylolisthesis reduction Inventor(s): Pisharodi; Madhavan (942 Wild Rose La., Brownsville, TX 78520) Assignee(s): None Reported Patent Number: 5,697,977 Date filed: June 7, 1995 Abstract: Method and apparatus for reduction of spondylolisthesis involving the insertion of an elongate implant which is split longitudinally into two side-by-side members, one of which is movable relative to the other, into the disk space between two misaligned vertebrae. Each of the members is provided with teeth for engaging the adjacent vertebrae and positioned on the members so as to be located on opposite sides of the implant. The implant formed by the two side-by-side members is generally rectangularly-shaped in cross section, the height of the rectangularly-shaped cross section being less than the width so that the implant can be inserted between the adjacent vertebrae with the lesser, height dimension oriented in the same direction as the axis of the spinal column and the larger width dimension at approximately a right angle to that axis. One of the two members is then moved relative to the other from the first position in which the members are in the abovedescribed, side-by-side relationship along the longitudinal axis of the implant to a second position in which the members are aligned with the respective, adjacent, misaligned vertebrae and the implant is then rotated by approximately 90.degree. to cause the teeth to contact the bodies of the adjacent vertebrae. The two members are then brought back into the first side-by-side relationship to draw the misaligned vertebrae into alignment and the implant is rotated approximately 90.degree. to disengage the teeth from the vertebrae for removal of the implant from the disk space. Excerpt(s): The present invention relates to a method and apparatus for reduction of spondylolisthesis, e.g., misalignment of the vertebrae comprising the spinal column. More specifically, the present invention relates to an apparatus which is inserted into the disk space between two adjacent, misaligned vertebrae, engages the bodies of the adjacent vertebrae, and pulls the adjacent vertebrae back into alignment and a method utilizing that apparatus. Treatment of disorders of the spinal column, especially in the cervical and lumbar regions, continues to be a challenging field of medicine. Classical treatments for conditions involving subluxation of one vertebrae upon another, resulting in misalignment of the spinal column, involve the use of screws which extend through a plate and which are tightened to draw the misaligned vertebrae back into

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alignment. However, such conditions often involve damage to the intervertebral disk, e.g., rupture or herniation, which may result in compression of a nerve root. If the herniation is large, compression may be bilateral. This condition is usually not corrected by re-aligning the vertebrae with a plate and screws such that surgical removal of the disk followed by fusion is often indicated after reduction of spondylolisthesis. However, diskectomy with fusion is not ideal because the replaced bone does not have the function of the cartilaginous tissue of the disk, i.e. no cushioning effect, and has complications because of several factors. First, conventional bone plugs used to pack the disk space do not conform to the space of the disk because the disk bulges maximally in the center. The disk space is wider in the middle and narrower at its anterior and posterior ends. For this reason, the various bone plugs which are currently available commercially have only four contact points, i.e. at the front and back of the disk space. Secondly, access to the disk is from the side of the dorsal spine of the adjacent vertebrae, leaving a space that is "off-center" relative to the bodies of the adjacent vertebrae such that the stability of the implant is even more problematical than might be apparent from the limited contact resulting from the shape of the intervertebral space. Another complication is the possibility of infection or other conditions which may require the removal of the implant. Also, if the bone pieces do not fuse, they may eventually extrude out of the disk space, causing pressure on the nerve roots. Web site: http://www.delphion.com/details?pn=US05697977__ •

Method and device for fixing and correcting spondylolisthesis anteriorly Inventor(s): Kuslich; Stephen D. (Stillwater, MN) Assignee(s): Spineology, Inc. (stillwater, Mn) Patent Number: 6,056,749 Date filed: March 15, 1999 Abstract: A method and apparatus for fixation and correction of spondylolisthesis anteriorly includes a disk cage which is inserted into the space between adjacent vertebrae, a drill guide for guiding and aligning a drill bit to angle an opening anteriorly between adjacent vertebrae, a distractor for temporarily aligning the vertebrae to position a disk cage and an elongated hollow screw positioned in said drilled opening through one vertebra, said disk cage and into said adjacent vertebra. Excerpt(s): This invention relates to a method and apparatus for fixation and reduction of spondylolisthesis, e.g., misalignment of the vertebrae comprising the spinal column. More specifically, the present invention relates to a disk cage positioned in the disk space between affected vertebra, and a screw through said vertebra, disk cage and other vertebra and a method utilizing that apparatus. Treatments for conditions involving subluxation of one vertebrae upon another, resulting in misalignment of the spinal column, involve the use of screws which extend through a plate and which are tightened to draw the misaligned vertebrae back into alignment. U.S. Pat. No. 5,531,747 to Ray (hereinafter "Ray") is an example of a plate and screw system for treating spondylolisthesis. Other approaches include insertion of an implant into the disk space between misaligned vertebrae such as shown in U.S. Pat. No. 5,601,556 to Pisharodi (hereinafter "Pisharodi"). The Ray approach has its limitations as discussed in Pisharodi. That patent has a disadvantage in requiring removal of the disk and having multiple steps, that is, two implants are inserted into the disk space only to be substituted later with monolithic implants, Schafer et al., in U.S. Pat. No. 5,800,547 discloses an angled block which is implanted into an intervertebral space. The block includes multiple

Patents 63

openings through which securing pins extend after they are pushed into position by a camming mechanism inserted into another opening in the device. The art described in this section is not intended to constitute an admission that any patent, publication or other information referred to herein is "prior art" with respect to this invention, unless specifically designated as such. In addition, this section should not be construed to mean that a search has been made or that no other pertinent information as defined in 37 C.F.R.sctn.1.56(a) exists. Web site: http://www.delphion.com/details?pn=US06056749__ •

Spinal fixation system Inventor(s): Middleton; Jeffrey Keith (132 Gathurst Lane, Shevington, Nr. Wigan, Lancashire WN6 8HS, GB) Assignee(s): None Reported Patent Number: 5,899,901 Date filed: November 1, 1995 Excerpt(s): This invention relates to apparatus for use in surgery. More specifically, it relates to a spinal fixation device which is adapted to engage a spinal body (e.g. vertebra, or sacrum) and to grip an elongate part, which may be a rod, bar, wire or the like. For any such elongate part, the term "rod" will hereinafter be used, for convenience. Two or more such devices may engage respective vertebrae and grip a common rod, which may act to improve a spinal defect, such as ankylosing spondylitis, lumbar scoliosis or spondylolisthesis. The invention also relates to surgical instrumentation for use with such a spinal fixation device. 1. A spinal body engagement part (hereinafter called a "screw") comprising a threaded shank to engage with a vertebra, and a head to project from the spinal body, in use, the head being formed with a passage, conveniently a slot open to the top of the head and extending across the width of the head, into which a rod which extends transversely of the screw may be moved. 2. A rod-clamping element (hereinafter called a "pad") which can be introduced into the head. When the passage is a slot as described above, the movement is longitudinally of the screw to overlie the rod, the pad being unable to leave the slot other than by reverse longitudinal movement. To this end, the head has a central bore, formed longitudinally of the screw. In plan view the pad is circular and it may be slid down the bore but is of too large a diameter to pass transversely out of the slot. When the head has a slot the bore is suitably coincident therewith. Web site: http://www.delphion.com/details?pn=US05899901__

•

System for stabilizing the cervical and the lumbar region of the spine Inventor(s): Ray; R. Charles (Tacoma, WA) Assignee(s): Danek Medical, Inc. (memphis, Tn) Patent Number: 5,470,333 Date filed: June 10, 1993 Abstract: A system for achieving reduction of curvature of the lumbar region of the spine associated with spondylolisthesis includes a hook assembly attached to vertebra L4, transverse plates affixed to vertebrae L4 and L5, and sacral plates affixed to opposite

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sides of the sacrum. The hooks and the plates in combination with the longitudinal plate along the posterior anterior plane in which the spinous processes lie allows for effective reduction of the curvature and secure fixation of this region of the spine. A related system for stabilizing the cervical region of the spine includes transverse plates affixed to vertebrae C3, C4, and C5. These plates in combination with a longitudinal plate allows for effective stabilization. The transverse plates include textured surfaces that allow them to mate in a manner which prevents undesirable slippage therebetween. The system is also compact and does not interfere with the paraspinal muscles which run along either side of the spinous processes. Excerpt(s): The present invention relates to surgical devices and methods for reducing deformity of the spine, particularly the cervical and lumbar regions, and holding these regions of the spine while a spine fusion heals. While the invention in one embodiment is capable of reducing mild rotational deformity, it particularly relates to the reduction of spondylolisthesis. In another embodiment, the present invention is capable of stabilizing the cervical region of the spine. Spondylolisthesis is a condition of the spine where one vertebra segment moves forward abnormally both in flexion (rotation) and translation relative to the vertebra immediately below it. This may be due to (a)torn soft tissue restraints (ligaments, joint capsules, etc.), (b) eroded and deformed joints (degenerating spondylolisthesis), or (c) a defect in the bone between the lamina, spinal process and transverse process as one unit and the rest of the vertebrae as a second unit (spondylolytic spondylolisthesis). When spondylolisthesis is present, the upper vertebral segment moves anteriorly in a sagittal plane both in an angular flexion, as well as a straight translational direction. Generally, treatment of spondylolisthesis corrects both types of displacement so that the flexion and translation of the upper element and the relative extension or translation of the lower element are both corrected to restore the normal lordotic alignment of the lumbar spine. Web site: http://www.delphion.com/details?pn=US05470333__

Patent Applications on Spondylolisthesis As of December 2000, U.S. patent applications are open to public viewing.7 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to spondylolisthesis: •

Facet arthroplasty devices and methods Inventor(s): Reiley, Mark A.; (Piedmont, CA) Correspondence: Ryan Kromholz & Manion, S.C.; Post Office Box 26618; Milwaukee; WI; 53226-0618; US Patent Application Number: 20040006391 Date filed: July 9, 2003 Abstract: Devices and surgical methods treat various types of adult spinal pathologies, such as degenerative spondylolisthesis, spinal stenosis, degenerative lumbar scoliosis, and kypho-scoliosis. Various types of spinal joint replacement prostheses, surgical

7

This has been a common practice outside the United States prior to December 2000.

Patents 65

procedures for performing spinal joint replacements, and surgical instruments are used to perform the surgical procedures. Excerpt(s): This application is a divisional of co-pending application Ser. No. 09/693,272 filed Oct. 20, 2000, which is a continuation-in-part of U.S. Provisional Patent Application Serial No. 60/160,891, filed Oct. 22, 1999, and entitled "Facet Arthroplasty Devices and Methods," which is incorporated herein by reference. The present invention generally relates to devices and surgical methods for the treatment of various types of spinal pathologies. More specifically, the present invention is directed to several different types of spinal joint replacement prostheses, surgical procedures for performing spinal joint replacements, and surgical instruments which may be used to perform the surgical procedures. Back pain is a common human ailment. In fact, approximately 50% of persons who are over 60 years old suffer from lower back pain. Although many incidences of back pain are due to sprains or muscle strains which tend to be selflimited, some back pain is the result of more chronic fibromuscular, osteoarthritic, or ankylosing spondolytic processes of the lumbosacral area. Particularly in the population of over 50 year olds, and most commonly in women, degenerative spine diseases such as degenerative spondylolisthesis and spinal stenosis occurs in a high percentage of the population. Iida, et al, 1989. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Keeping Current In order to stay informed about patents and patent applications dealing with spondylolisthesis, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “spondylolisthesis” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on spondylolisthesis. You can also use this procedure to view pending patent applications concerning spondylolisthesis. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 5. BOOKS ON SPONDYLOLISTHESIS Overview This chapter provides bibliographic book references relating to spondylolisthesis. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on spondylolisthesis include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “spondylolisthesis” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “spondylolisthesis” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “spondylolisthesis” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

Severe Spondylolisthesis by J. Harms (Editor), H. Sturtz (Editor); ISBN: 3798512531; http://www.amazon.com/exec/obidos/ASIN/3798512531/icongroupinterna

The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “spondylolisthesis” (or synonyms) into the search box, and select “books

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only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:8 •

Lumbar breakdown caused by erect posture in man; with emphasis on spondylolisthesis and herniated intervertebral discs. Author: Thieme, Frederick P; Year: 1950

•

Severe spondylolisthesis: pathology, diagnosis, therapy. Author: J. Harms, H. Stürz, eds; Year: 2002

•

Spondylolisthesis; a study of 53 cases treated by spine fusion and 32 cases treated by laminectomy. Author: Laurent, Lars Erik; Year: 1958

•

Studies on spondylolisthesis. Author: Friberg, Sten Axel, 1902-; Year: 1939

Chapters on Spondylolisthesis In order to find chapters that specifically relate to spondylolisthesis, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and spondylolisthesis using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “spondylolisthesis” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on spondylolisthesis: •

Spinal Problems in Children Source: in Maddison, P.J.; et al., Eds. Oxford Textbook of Rheumatology. Volume 1. New York, NY: Oxford University Press, Inc. 1993. p. 55-69. Contact: Available from Oxford University Press, Inc., New York, NY. Summary: This chapter for health professionals discusses spinal disorders in children. Diagnoses suggested by various findings from a child's medical history and a physical examination are presented. Nonspecific causes of back pain are identified. Specific causes of back pain in childhood and adolescence are described, including benign and malignant spinal tumors, spinal infection, a prolapsed intervertebral disc, Scheuermann's osteochondritis, spondylolysis and spondylolisthesis, congenital anomalies, inflammatory disorders, juvenile osteoporosis, and trauma. In addition, the causes of spinal deformities such as structural and nonstructural scoliosis, kyphosis, lordosis are discussed. 55 references, 19 figures, and 4 tables.

8

In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a "Books" button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created between the books and other types of information, such as gene and protein sequences and macromolecular structures. See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Books.

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•

Chapter 8-C: Musculoskeletal Signs and Symptoms: Disorders of the Low Back and Neck Source: in Klippel, J.H., et al., eds. Primer on the Rheumatic Diseases. 12th ed. Atlanta, GA: Arthritis Foundation. 2001. p. 165-173. Contact: Available from Arthritis Foundation. P.O. Box 1616, Alpharetta, GA 300091616. (800) 207-8633. Fax (credit card orders only) (770) 442-9742. Website: www.arthritis.org. PRICE: $69.95 plus shipping and handling. ISBN: 0912423293. Summary: This chapter provides health professionals with information on disorders of the low back and neck. Axial skeletal pain is associated with various mechanical and medical disorders. Mechanical disorders are caused by overuse, trauma, or physical deformity of an anatomic structure. Medical disorders responsible for spinal pain are associated with constitutional symptoms, disease in other organ systems, and inflammatory or infiltrative disease of the axial skeleton. Most people who have low back or neck pain have a mechanical reason for their pain. The initial evaluation of patients with spinal pain focuses on separating people with mechanical disorders from those with systemic illnesses. The initial diagnostic evaluation includes taking a medical history and performing physical and neurologic examinations. Plain radiographs and laboratory tests are usually not needed for most patients. Symptoms that help identify systemic illnesses in people who have spinal pain include fever or weight loss, pain with recumbency, morning stiffness, localized bone pain, or visceral pain. Mechanical disorders of the lumbosacral spine are the most common causes of low back pain. These disorders include muscle strain, herniated nucleus pulposus, osteoarthritis, lumbar spinal stenosis, spondylolisthesis, and adult scoliosis. Mechanical disorders of the cervical spine are less common than lumbar spine disorders and tend to be less debilitating. Causes of cervical spine pain include neck strain, cervical disc herniation, cervical spondylosis, myelopathy, and whiplash. The chapter describes the clinical features, diagnosis, and treatment of these mechanical causes of back and neck pain. 3 figures, 5 tables, and 27 references.

•

Section Eight: Spine Source: in Greene, W.B., Ed. Essentials of Musculoskeletal Care. 2nd ed. Rosemont, IL: American Academy of Orthopaedic Surgeons (AAOS). 2001. p. 518-576. Contact: Available from American Academy of Orthopaedic Surgeons (AAOS). 6300 North River Road, Rosemont, IL 60018-4262. (800) 626-6726 (toll-free) or (847) 823-7186. Fax (800) 823-8025 (toll-free) or (847) 823-8025. E-mail: [email protected]. Website: www.aaos.org. PRICE: $105.00 for nonmembers; $90.00 AAOS members; $80.00 for residents; plus shipping and handling. ISBN 0892032170. Summary: This section of a book on musculoskeletal care provides health professionals with information on common conditions affecting the spine, including acute and chronic or repetitive injuries and degenerative, inflammatory, or idiopathic conditions. The section begins with information on the principles of evaluating and examining a patient presenting with a back complaint, focusing on inspection, palpation, range of motion, muscle testing, and special testing. This is followed by descriptions of cauda equina syndrome; cervical radiculopathy, spondylosis, and sprain; fracture of the cervical, thoracic, and lumbar spine; low back sprain; lumbar degenerative disk disease; lumbar herniated disk; lumbar spinal stenosis; metastatic disease; scoliosis in adults; and degenerative and isthmic spondylolisthesis. Information includes synonyms for and red flags associated with each condition; the definition, clinical symptoms, diagnosis, differential diagnosis, adverse outcomes, and treatment of the condition; diagnostic

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tests; and adverse treatment outcomes. Other topics include orthotic devices for the cervical, thoracic, and lumbar regions. 66 figures and 4 tables.

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APPENDICES

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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute9: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

•

National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

•

National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

•

National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

•

National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

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National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

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National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

•

National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

9

These publications are typically written by one or more of the various NIH Institutes.

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National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

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National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

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National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

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National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

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National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

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National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

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National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

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National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

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National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

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National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

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National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

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National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

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Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

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National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

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National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

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Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

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Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.10 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:11 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

•

HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

•

NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

•

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

•

Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

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Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

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Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

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Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

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Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

•

Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

•

MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

10

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 11 See http://www.nlm.nih.gov/databases/databases.html.

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Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html

The NLM Gateway12 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.13 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “spondylolisthesis” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 3134 35 8 0 18 3195

HSTAT14 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.15 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.16 Simply search by “spondylolisthesis” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

12

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

13

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 14 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 15 16

The HSTAT URL is http://hstat.nlm.nih.gov/.

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.

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Coffee Break: Tutorials for Biologists17 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.18 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.19 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

The Genome Project and Spondylolisthesis In the following section, we will discuss databases and references which relate to the Genome Project and spondylolisthesis. Online Mendelian Inheritance in Man (OMIM) The Online Mendelian Inheritance in Man (OMIM) database is a catalog of human genes and genetic disorders authored and edited by Dr. Victor A. McKusick and his colleagues at Johns Hopkins and elsewhere. OMIM was developed for the World Wide Web by the National Center for Biotechnology Information (NCBI).20 The database contains textual information, pictures, and reference information. It also contains copious links to NCBI’s Entrez database of MEDLINE articles and sequence information. 17 Adapted 18

from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 19 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process. 20 Adapted from http://www.ncbi.nlm.nih.gov/. Established in 1988 as a national resource for molecular biology information, NCBI creates public databases, conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information--all for the better understanding of molecular processes affecting human health and disease.

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To search the database, go to http://www.ncbi.nlm.nih.gov/Omim/searchomim.html. Type “spondylolisthesis” (or synonyms) into the search box, and click “Submit Search.” If too many results appear, you can narrow the search by adding the word “clinical.” Each report will have additional links to related research and databases. In particular, the option “Database Links” will search across technical databases that offer an abundance of information. The following is an example of the results you can obtain from the OMIM for spondylolisthesis: •

Spondylolisthesis Web site: http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=184200 Genes and Disease (NCBI - Map)

The Genes and Disease database is produced by the National Center for Biotechnology Information of the National Library of Medicine at the National Institutes of Health. This Web site categorizes each disorder by system of the body. Go to http://www.ncbi.nlm.nih.gov/disease/, and browse the system pages to have a full view of important conditions linked to human genes. Since this site is regularly updated, you may wish to revisit it from time to time. The following systems and associated disorders are addressed: •

Cancer: Uncontrolled cell division. Examples: Breast and ovarian cancer, Burkitt lymphoma, chronic myeloid leukemia, colon cancer, lung cancer, malignant melanoma, multiple endocrine neoplasia, neurofibromatosis, p53 tumor suppressor, pancreatic cancer, prostate cancer, Ras oncogene, RB: retinoblastoma, von Hippel-Lindau syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Cancer.html

•

Immune System: Fights invaders. Examples: Asthma, autoimmune polyglandular syndrome, Crohn’s disease, DiGeorge syndrome, familial Mediterranean fever, immunodeficiency with Hyper-IgM, severe combined immunodeficiency. Web site: http://www.ncbi.nlm.nih.gov/disease/Immune.html

•

Metabolism: Food and energy. Examples: Adreno-leukodystrophy, atherosclerosis, Best disease, Gaucher disease, glucose galactose malabsorption, gyrate atrophy, juvenile-onset diabetes, obesity, paroxysmal nocturnal hemoglobinuria, phenylketonuria, Refsum disease, Tangier disease, Tay-Sachs disease. Web site: http://www.ncbi.nlm.nih.gov/disease/Metabolism.html

•

Muscle and Bone: Movement and growth. Examples: Duchenne muscular dystrophy, Ellis-van Creveld syndrome, Marfan syndrome, myotonic dystrophy, spinal muscular atrophy. Web site: http://www.ncbi.nlm.nih.gov/disease/Muscle.html

•

Nervous System: Mind and body. Examples: Alzheimer disease, amyotrophic lateral sclerosis, Angelman syndrome, Charcot-Marie-Tooth disease, epilepsy, essential tremor, fragile X syndrome, Friedreich’s ataxia, Huntington disease, Niemann-Pick disease, Parkinson disease, Prader-Willi syndrome, Rett syndrome, spinocerebellar atrophy, Williams syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Brain.html

Physician Resources 79

•

Signals: Cellular messages. Examples: Ataxia telangiectasia, Cockayne syndrome, glaucoma, male-patterned baldness, SRY: sex determination, tuberous sclerosis, Waardenburg syndrome, Werner syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Signals.html

•

Transporters: Pumps and channels. Examples: Cystic fibrosis, deafness, diastrophic dysplasia, Hemophilia A, long-QT syndrome, Menkes syndrome, Pendred syndrome, polycystic kidney disease, sickle cell anemia, Wilson’s disease, Zellweger syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Transporters.html Entrez

Entrez is a search and retrieval system that integrates several linked databases at the National Center for Biotechnology Information (NCBI). These databases include nucleotide sequences, protein sequences, macromolecular structures, whole genomes, and MEDLINE through PubMed. Entrez provides access to the following databases: •

3D Domains: Domains from Entrez Structure, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo

•

Books: Online books, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=books

•

Genome: Complete genome assemblies, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Genome

•

NCBI’s Protein Sequence Information Survey Results: Web site: http://www.ncbi.nlm.nih.gov/About/proteinsurvey/

•

Nucleotide Sequence Database (Genbank): Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Nucleotide

•

OMIM: Online Mendelian Inheritance in Man, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=OMIM

•

PopSet: Population study data sets, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Popset

•

ProbeSet: Gene Expression Omnibus (GEO), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo

•

Protein Sequence Database: Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Protein

•

PubMed: Biomedical literature (PubMed), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed

•

Structure: Three-dimensional macromolecular structures, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Structure

•

Taxonomy: Organisms in GenBank, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Taxonomy

To access the Entrez system at the National Center for Biotechnology Information, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=genome, and then

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select the database that you would like to search. The databases available are listed in the drop box next to “Search.” Enter “spondylolisthesis” (or synonyms) into the search box and click “Go.” Jablonski’s Multiple Congenital Anomaly/Mental Retardation (MCA/MR) Syndromes Database21 This online resource has been developed to facilitate the identification and differentiation of syndromic entities. Special attention is given to the type of information that is usually limited or completely omitted in existing reference sources due to space limitations of the printed form. At http://www.nlm.nih.gov/mesh/jablonski/syndrome_toc/toc_a.html, you can search across syndromes using an alphabetical index. Search by keywords at http://www.nlm.nih.gov/mesh/jablonski/syndrome_db.html. The Genome Database22 Established at Johns Hopkins University in Baltimore, Maryland in 1990, the Genome Database (GDB) is the official central repository for genomic mapping data resulting from the Human Genome Initiative. In the spring of 1999, the Bioinformatics Supercomputing Centre (BiSC) at the Hospital for Sick Children in Toronto, Ontario assumed the management of GDB. The Human Genome Initiative is a worldwide research effort focusing on structural analysis of human DNA to determine the location and sequence of the estimated 100,000 human genes. In support of this project, GDB stores and curates data generated by researchers worldwide who are engaged in the mapping effort of the Human Genome Project (HGP). GDB’s mission is to provide scientists with an encyclopedia of the human genome which is continually revised and updated to reflect the current state of scientific knowledge. Although GDB has historically focused on gene mapping, its focus will broaden as the Genome Project moves from mapping to sequence, and finally, to functional analysis. To access the GDB, simply go to the following hyperlink: http://www.gdb.org/. Search “All Biological Data” by “Keyword.” Type “spondylolisthesis” (or synonyms) into the search box, and review the results. If more than one word is used in the search box, then separate each one with the word “and” or “or” (using “or” might be useful when using synonyms).

21

Adapted from the National Library of Medicine: http://www.nlm.nih.gov/mesh/jablonski/about_syndrome.html. 22 Adapted from the Genome Database: http://gdbwww.gdb.org/gdb/aboutGDB.html - mission.

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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on spondylolisthesis can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to spondylolisthesis. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to spondylolisthesis. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “spondylolisthesis”:

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Back Injuries http://www.nlm.nih.gov/medlineplus/backinjuries.html Spinal Diseases http://www.nlm.nih.gov/medlineplus/spinaldiseases.html Spinal Stenosis http://www.nlm.nih.gov/medlineplus/spinalstenosis.html You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on spondylolisthesis. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •

Spondylolysis and Spondylolisthesis Source: American Academy of Orthopaedic Surgeons. June 2000. 2 p. Contact: Available online from American Academy of Orthopaedic Surgeons. Website: www.aaos.org. Summary: This fact sheet discusses spondylolysis and spondylolisthesis, two conditions that result from stress fractures in the low back. In spondylolysis, the fourth or fifth lumbar vertebra in the lower back is affected. In spondylolisthesis, the bone is weakened so much that the vertebra can start to slip out of position. These conditions may be caused by genetics, overuse, and degenerative changes in the vertebral joints. Symptoms include pain across the lower back and spasms that may lead to gait and posture changes. Doctors may use x-rays of the lower back and CT scans or MRIs to confirm diagnosis. Initial conservative treatment for spondylolysis includes taking a break from the symptom-causing activity, taking NSAIDs, using a back brace, and performing physical therapy. Stretching and strengthening exercises may help prevent future stress fractures. Surgery may be needed if the bone continues to slip and consists of a decompressive laminectomy to relieve nerve compression and a spinal fusion to ensure spinal stability.

•

Adult Isthmic Spondylolisthesis (Slipped Vertebra) Source: LaGrange, IL: North American Spine Society (NASS). 2001. 8 p. Contact: Available from North American Spine Society. For bulk orders write to: NASS, Dept 77-6663, Chicago, IL 60678-6663. For single copies write to: NASS, 22 Calendar

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Court, 2nd Floor, LaGrange, IL 60525. (877) SPINE-DR. Fax (708) 588-1080. E-Mail: [email protected]. Website: www.spine.org. PRICE: Sets of 25 for $15.00 (members) or $20.00 (nonmembers); single copy free (send self-addressed, stamped envelope). Summary: This full color patient education brochure uses a question and answer format to provide people who have adult isthmic spondylolisthesis (slipped vertebrae) with information on its symptoms, diagnosis, and treatment. This condition occurs when a cracked vertebrae slips forward over the vertebrae below it. Although the condition may not cause symptoms for years after the slippage has occurred, when they do occur, they may include low back and buttocks pain; numbness, tingling, pain, muscle tightness, or weakness in the leg; increased sway back; or a limp. Diagnosis is based on the medical history, physical examination, and diagnostic imaging studies. Treatment is aimed at pain relief and functional improvement. Nonsurgical treatments are usually tried at first following a diagnosis of spondylolisthesis. These treatments may include a short period of rest, antiinflammatory drugs, analgesic drugs, bracing, physical therapy, and exercise. Surgery is reserved for those whose pain cannot be relieved by nonsurgical treatment methods. If a spinal nerve is being compressed by a forward slip, surgery may be needed to reopen a space for the nerve. A stabilizing procedure or fusion may also be recommended. 2 figures. The National Guideline Clearinghouse™ The National Guideline Clearinghouse™ offers hundreds of evidence-based clinical practice guidelines published in the United States and other countries. You can search this site located at http://www.guideline.gov/ by using the keyword “spondylolisthesis” (or synonyms). The following was recently posted: •

Spondylolysis, lytic spondylolisthesis and degenerative spondylolisthesis (SLD). In: North American Spine Society phase III clinical guidelines for multidisciplinary spine care specialists Source: North American Spine Society - Medical Specialty Society; 2000; 106 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2804&nbr=2030&a mp;string=spondylolisthesis The NIH Search Utility

The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to spondylolisthesis. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html.

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Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/specific.htm

•

Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

•

Med Help International: http://www.medhelp.org/HealthTopics/A.html

•

Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

•

Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

•

WebMDHealth: http://my.webmd.com/health_topics

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to spondylolisthesis. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with spondylolisthesis. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about spondylolisthesis. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “spondylolisthesis” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received

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your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “spondylolisthesis”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “spondylolisthesis” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “spondylolisthesis” (or a synonym) into the search box, and click “Submit Query.”

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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.23

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

23

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)24: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

•

Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

•

Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

•

California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

•

California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

•

California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

•

California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

•

California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

•

California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

•

California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

•

California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

•

California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

•

California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

•

Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

•

Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

•

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

24

Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.

Finding Medical Libraries 89

•

Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

•

Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

•

Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

•

Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

•

Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

•

Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

•

Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

•

Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

•

Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

•

Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

•

Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

•

Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

•

Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

•

Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

•

Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

•

Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

•

Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

•

Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

•

Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

•

Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

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•

Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

•

Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

•

Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

•

Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

•

Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

•

Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

•

Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

•

Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

•

Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

•

Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

•

Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

•

Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

•

Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

•

Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

•

Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

•

Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

•

National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

•

National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

•

National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

Finding Medical Libraries 91

•

Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm

•

New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/

•

New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

•

New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

•

New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

•

New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

•

New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

•

New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

•

New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

•

Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

•

Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

•

Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

•

Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

•

Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

•

Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

•

Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

•

Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

•

Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

•

Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

•

Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

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•

South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

•

Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

•

Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

•

Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

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ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

•

MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

•

Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

•

Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

•

On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

•

Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

•

Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on spondylolisthesis: •

Basic Guidelines for Spondylolisthesis Spondylolisthesis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001260.htm

•

Signs & Symptoms for Spondylolisthesis Back pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003108.htm Lordosis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003278.htm Muscle Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003193.htm Pain in the back Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003108.htm

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Stress Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003211.htm •

Diagnostics and Tests for Spondylolisthesis X-ray of the spine Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003806.htm

•

Surgery and Procedures for Spondylolisthesis Spinal fusion Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002968.htm

•

Background Topics for Spondylolisthesis Anterior Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002232.htm Fracture Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000001.htm Fractures Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000001.htm

Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

•

MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

•

Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

•

Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

95

SPONDYLOLISTHESIS DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Ablation: The removal of an organ by surgery. [NIH] Activities of Daily Living: The performance of the basic activities of self care, such as dressing, ambulation, eating, etc., in rehabilitation. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adolescence: The period of life beginning with the appearance of secondary sex characteristics and terminating with the cessation of somatic growth. The years usually referred to as adolescence lie between 13 and 18 years of age. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Aerobic Exercise: A type of physical activity that includes walking, jogging, running, and dancing. Aerobic training improves the efficiency of the aerobic energy-producing systems that can improve cardiorespiratory endurance. [NIH] Alum: A type of immune adjuvant (a substance used to help boost the immune response to a vaccine). Also called aluminum sulfate. [NIH] Aluminum: A metallic element that has the atomic number 13, atomic symbol Al, and atomic weight 26.98. [NIH] Amino acid: Any organic compound containing an amino (-NH2 and a carboxyl (- COOH) group. The 20 a-amino acids listed in the accompanying table are the amino acids from which proteins are synthesized by formation of peptide bonds during ribosomal translation of messenger RNA; all except glycine, which is not optically active, have the L configuration. Other amino acids occurring in proteins, such as hydroxyproline in collagen, are formed by posttranslational enzymatic modification of amino acids residues in polypeptide chains. There are also several important amino acids, such as the neurotransmitter y-aminobutyric acid, that have no relation to proteins. Abbreviated AA. [EU] Ampulla: A sac-like enlargement of a canal or duct. [NIH] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Anomalies: Birth defects; abnormalities. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on

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the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Aqueous: Having to do with water. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arthroplasty: Surgical reconstruction of a joint to relieve pain or restore motion. [NIH] Articular: Of or pertaining to a joint. [EU] Aseptic: Free from infection or septic material; sterile. [EU] Asymptomatic: Having no signs or symptoms of disease. [NIH] Ataxia: Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs, trunk, eyes, pharnyx, larnyx, and other structures. Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or peripheral nerve diseases. Motor ataxia may be associated with cerebellar diseases; cerebral cortex diseases; thalamic diseases; basal ganglia diseases; injury to the red nucleus; and other conditions. [NIH] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Autonomic Dysreflexia: That part of the nervous system concerned with the unconscious regulation of the living processes of the body. [NIH] Back Pain: Acute or chronic pain located in the posterior regions of the trunk, including the thoracic, lumbar, sacral, or adjacent regions. [NIH] Basal cell carcinoma: A type of skin cancer that arises from the basal cells, small round cells found in the lower part (or base) of the epidermis, the outer layer of the skin. [NIH] Basal cells: Small, round cells found in the lower part (or base) of the epidermis, the outer layer of the skin. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Basal Ganglia Diseases: Diseases of the basal ganglia including the putamen; globus pallidus; claustrum; amygdala; and caudate nucleus. Dyskinesias (most notably involuntary movements and alterations of the rate of movement) represent the primary clinical manifestations of these disorders. Common etiologies include cerebrovascular disease; neurodegenerative diseases; and craniocerebral trauma. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU]

Dictionary 97

Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Bifida: A defect in development of the vertebral column in which there is a central deficiency of the vertebral lamina. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biomechanics: The study of the application of mechanical laws and the action of forces to living structures. [NIH] Bladder: The organ that stores urine. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Bone scan: A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Brace: Any form of splint or appliance used to support the limbs or trunk. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Breakdown: A physical, metal, or nervous collapse. [NIH] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carcinogens: Substances that increase the risk of neoplasms in humans or animals. Both genotoxic chemicals, which affect DNA directly, and nongenotoxic chemicals, which induce neoplasms by other mechanism, are included. [NIH] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

Cardiopulmonary: Having to do with the heart and lungs. [NIH] Cardiorespiratory: Relating to the heart and lungs and their function. [EU] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Cauda Equina: The lower part of the spinal cord consisting of the lumbar, sacral, and coccygeal nerve roots. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Cell: The individual unit that makes up all of the tissues of the body. All living things are

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made up of one or more cells. [NIH] Cell Division: The fission of a cell. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebellar Diseases: Diseases that affect the structure or function of the cerebellum. Cardinal manifestations of cerebellar dysfunction include dysmetria, gait ataxia, and muscle hypotonia. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Cortex: The thin layer of gray matter on the surface of the cerebral hemisphere that develops from the telencephalon and folds into gyri. It reaches its highest development in man and is responsible for intellectual faculties and higher mental functions. [NIH] Cerebral Palsy: Refers to a motor disability caused by a brain dysfunction. [NIH] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Chymopapain: A cysteine endopeptidase isolated from papaya latex. Preferential cleavage at glutamic and aspartic acid residues. EC 3.4.22.6. [NIH] Claudication: Limping or lameness. [EU] Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and

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leaves the body through the anus. [NIH] Compliance: Distensibility measure of a chamber such as the lungs (lung compliance) or bladder. Compliance is expressed as a change in volume per unit change in pressure. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Computed tomography: CT scan. A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized tomography and computerized axial tomography (CAT) scan. [NIH] Concomitant: Accompanying; accessory; joined with another. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constitutional: 1. Affecting the whole constitution of the body; not local. 2. Pertaining to the constitution. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Contralateral: Having to do with the opposite side of the body. [NIH] Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Criterion: A standard by which something may be judged. [EU] Decompression: Decompression external to the body, most often the slow lessening of external pressure on the whole body (especially in caisson workers, deep sea divers, and persons who ascend to great heights) to prevent decompression sickness. It includes also sudden accidental decompression, but not surgical (local) decompression or decompression applied through body openings. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Diagnosis, Differential: Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diencephalon: The paired caudal parts of the prosencephalon from which the thalamus, hypothalamus, epithalamus, and subthalamus are derived. [NIH]

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Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discitis: Inflammation of an intervertebral disk or disk space which may lead to disk erosion. Until recently, discitis has been defined as a nonbacterial inflammation and has been attributed to aseptic processes (e.g., chemical reaction to an injected substance). However, recent studies provide evidence that infection may be the initial cause, but perhaps not the promoter, of most cases of discitis. Discitis has been diagnosed in patients following discography, myelography, lumbar puncture, paravertebral injection, and obstetrical epidural anesthesia. Discitis following chemonucleolysis (especially with chymopapain) is attributed to chemical reaction by some and to introduction of microorganisms by others. [NIH] Diskectomy: Excision, in part or whole, of an intervertebral disk. The most common indication is disk displacement or herniation. In addition to standard surgical removal, it can be performed by percutaneous diskectomy or by laparoscopic diskectomy, the former being the more common. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Duct: A tube through which body fluids pass. [NIH] Duodenum: The first part of the small intestine. [NIH] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Elective: Subject to the choice or decision of the patient or physician; applied to procedures that are advantageous to the patient but not urgent. [EU] Emulsion: A preparation of one liquid distributed in small globules throughout the body of a second liquid. The dispersed liquid is the discontinuous phase, and the dispersion medium is the continuous phase. When oil is the dispersed liquid and an aqueous solution is the continuous phase, it is known as an oil-in-water emulsion, whereas when water or aqueous solution is the dispersed phase and oil or oleaginous substance is the continuous phase, it is known as a water-in-oil emulsion. Pharmaceutical emulsions for which official standards have been promulgated include cod liver oil emulsion, cod liver oil emulsion with malt, liquid petrolatum emulsion, and phenolphthalein in liquid petrolatum emulsion. [EU] Endoscope: A thin, lighted tube used to look at tissues inside the body. [NIH] Endoscopic: A technique where a lateral-view endoscope is passed orally to the duodenum for visualization of the ampulla of Vater. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Environmental Exposure: The exposure to potentially harmful chemical, physical, or

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biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epidural: The space between the wall of the spinal canal and the covering of the spinal cord. An epidural injection is given into this space. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Essential Tremor: A rhythmic, involuntary, purposeless, oscillating movement resulting from the alternate contraction and relaxation of opposing groups of muscles. [NIH] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Femur: The longest and largest bone of the skeleton, it is situated between the hip and the knee. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fixation: 1. The act or operation of holding, suturing, or fastening in a fixed position. 2. The condition of being held in a fixed position. 3. In psychiatry, a term with two related but distinct meanings : (1) arrest of development at a particular stage, which like regression (return to an earlier stage), if temporary is a normal reaction to setbacks and difficulties but if protracted or frequent is a cause of developmental failures and emotional problems, and (2) a close and suffocating attachment to another person, especially a childhood figure, such as one's mother or father. Both meanings are derived from psychoanalytic theory and refer to 'fixation' of libidinal energy either in a specific erogenous zone, hence fixation at the oral, anal, or phallic stage, or in a specific object, hence mother or father fixation. 4. The use of a fixative (q.v.) to preserve histological or cytological specimens. 5. In chemistry, the process whereby a substance is removed from the gaseous or solution phase and localized, as in carbon dioxide fixation or nitrogen fixation. 6. In ophthalmology, direction of the gaze so that the visual image of the object falls on the fovea centralis. 7. In film processing, the chemical removal of all undeveloped salts of the film emulsion, leaving only the developed silver to form a permanent image. [EU] Flexion: In gynaecology, a displacement of the uterus in which the organ is bent so far forward or backward that an acute angle forms between the fundus and the cervix. [EU] Foramen: A natural hole of perforation, especially one in a bone. [NIH] Fovea: The central part of the macula that provides the sharpest vision. [NIH] Fundus: The larger part of a hollow organ that is farthest away from the organ's opening. The bladder, gallbladder, stomach, uterus, eye, and cavity of the middle ear all have a

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fundus. [NIH] Gait: Manner or style of walking. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Grafting: The operation of transfer of tissue from one site to another. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemoglobinuria: The presence of free hemoglobin in the urine. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Herniated: Protrusion of a degenerated or fragmented intervertebral disc into the intervertebral foramen compressing the nerve root. [NIH]

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Hormonal: Pertaining to or of the nature of a hormone. [EU] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Immune adjuvant: A drug that stimulates the immune system to respond to disease. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Intermittent Claudication: A symptom complex characterized by leg pain and weakness brought on by walking, with the disappearance of the symptoms following a brief rest. [NIH] Intervertebral: Situated between two contiguous vertebrae. [EU] Intervertebral Disk Displacement: An intervertebral disk in which the nucleus pulposus has protruded through surrounding fibrocartilage. This occurs most frequently in the lower lumbar region. [NIH] Intestinal: Having to do with the intestines. [NIH] Intracellular: Inside a cell. [NIH]

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Intravenous: IV. Into a vein. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Involuntary: Reaction occurring without intention or volition. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Isometric Contraction: Muscular contractions characterized by increase in tension without change in length. [NIH] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Joint Capsule: The sac enclosing a joint. It is composed of an outer fibrous articular capsule and an inner synovial membrane. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kyphosis: A deformity of the spine characterized by extensive flexion. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Leukemia: Cancer of blood-forming tissue. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Lipoma: A benign tumor composed of fat cells. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver scan: An image of the liver created on a computer screen or on film. A radioactive substance is injected into a blood vessel and travels through the bloodstream. It collects in the liver, especially in abnormal areas, and can be detected by the scanner. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Long-Term Care: Care over an extended period, usually for a chronic condition or disability, requiring periodic, intermittent, or continuous care. [NIH] Lordosis: The anterior concavity in the curvature of the lumbar and cervical spine as viewed from the side. The term usually refers to abnormally increased curvature (hollow back, saddle back, swayback). It does not include lordosis as normal mating posture in certain animals ( = posture + sex behavior, animal). [NIH] Lordotic: An investigation of the chest for which the body is arched backwards from the

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waist and the useful beam enters from behind. [NIH] Low Back Pain: Acute or chronic pain in the lumbar or sacral regions, which may be associated with musculo-ligamentous sprains and strains; intervertebral disk displacement; and other conditions. [NIH] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lumbar puncture: A procedure in which a needle is put into the lower part of the spinal column to collect cerebrospinal fluid or to give anticancer drugs intrathecally. Also called a spinal tap. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Lytic: 1. Pertaining to lysis or to a lysin. 2. Producing lysis. [EU] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Meta-Analysis: A quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions

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which may be used to evaluate therapeutic effectiveness, plan new studies, etc., with application chiefly in the areas of research and medicine. [NIH] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] Metastatic: Having to do with metastasis, which is the spread of cancer from one part of the body to another. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Mobility: Capability of movement, of being moved, or of flowing freely. [EU] Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Muscle Fibers: Large single cells, either cylindrical or prismatic in shape, that form the basic unit of muscle tissue. They consist of a soft contractile substance enclosed in a tubular sheath. [NIH] Muscular Atrophy: Derangement in size and number of muscle fibers occurring with aging, reduction in blood supply, or following immobilization, prolonged weightlessness, malnutrition, and particularly in denervation. [NIH] Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH] Myelography: X-ray visualization of the spinal cord following injection of contrast medium into the spinal arachnoid space. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myotonic Dystrophy: A condition presenting muscle weakness and wasting which may be progressive. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Neck Pain: Discomfort or more intense forms of pain that are localized to the cervical region. This term generally refers to pain in the posterior or lateral regions of the neck. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neoplasia: Abnormal and uncontrolled cell growth. [NIH]

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Neoplasm: A new growth of benign or malignant tissue. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nephropathy: Disease of the kidneys. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neurogenic: Loss of bladder control caused by damage to the nerves controlling the bladder. [NIH] Neurologic: Having to do with nerves or the nervous system. [NIH] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neurosyphilis: A late form of syphilis that affects the brain and may lead to dementia and death. [NIH] Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Oncogene: A gene that normally directs cell growth. If altered, an oncogene can promote or allow the uncontrolled growth of cancer. Alterations can be inherited or caused by an environmental exposure to carcinogens. [NIH] Ophthalmology: A surgical specialty concerned with the structure and function of the eye and the medical and surgical treatment of its defects and diseases. [NIH] Optic cup: The white, cup-like area in the center of the optic disc. [NIH] Optic Nerve: The 2nd cranial nerve. The optic nerve conveys visual information from the retina to the brain. The nerve carries the axons of the retinal ganglion cells which sort at the optic chiasm and continue via the optic tracts to the brain. The largest projection is to the lateral geniculate nuclei; other important targets include the superior colliculi and the suprachiasmatic nuclei. Though known as the second cranial nerve, it is considered part of the central nervous system. [NIH] Orthotic Devices: Apparatus used to support, align, prevent, or correct deformities or to improve the function of movable parts of the body. [NIH] Osteoarthritis: A progressive, degenerative joint disease, the most common form of arthritis, especially in older persons. The disease is thought to result not from the aging process but from biochemical changes and biomechanical stresses affecting articular cartilage. In the foreign literature it is often called osteoarthrosis deformans. [NIH] Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal

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osteoporosis and age-related (or senile) osteoporosis. [NIH] Palpation: Application of fingers with light pressure to the surface of the body to determine consistence of parts beneath in physical diagnosis; includes palpation for determining the outlines of organs. [NIH] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic cancer: Cancer of the pancreas, a salivary gland of the abdomen. [NIH] Paralysis: Loss of ability to move all or part of the body. [NIH] Paraparesis: Mild to moderate loss of bilateral lower extremity motor function, which may be a manifestation of spinal cord diseases; peripheral nervous system diseases; muscular diseases; intracranial hypertension; parasagittal brain lesions; and other conditions. [NIH] Paresis: A general term referring to a mild to moderate degree of muscular weakness, occasionally used as a synonym for paralysis (severe or complete loss of motor function). In the older literature, paresis often referred specifically to paretic neurosyphilis. "General paresis" and "general paralysis" may still carry that connotation. Bilateral lower extremity paresis is referred to as paraparesis. [NIH] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathologies: The study of abnormality, especially the study of diseases. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Patient Satisfaction: The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial. [NIH] Pedicle: Embryonic link between the optic vesicle or optic cup and the forebrain or diencephalon, which becomes the optic nerve. [NIH] Pelvic: Pertaining to the pelvis. [EU] Pelvis: The lower part of the abdomen, located between the hip bones. [NIH] Percutaneous: Performed through the skin, as injection of radiopacque material in radiological examination, or the removal of tissue for biopsy accomplished by a needle. [EU] Perforation: 1. The act of boring or piercing through a part. 2. A hole made through a part or substance. [EU] Phallic: Pertaining to the phallus, or penis. [EU] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physical Therapy: The restoration of function and the prevention of disability following disease or injury with the use of light, heat, cold, water, electricity, ultrasound, and exercise.

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[NIH]

Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Polycystic: An inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time. These cysts take over and destroy working kidney tissue. PKD may cause chronic renal failure and end-stage renal disease. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Postoperative: After surgery. [NIH] Practicability: A non-standard characteristic of an analytical procedure. It is dependent on the scope of the method and is determined by requirements such as sample throughout and costs. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Preoperative: Preceding an operation. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH]

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Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulposus: Prolapse of the nucleus pulposus into the body of the vertebra; necrobacillosis of rabbits. [NIH] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radicular: Having the character of or relating to a radicle or root. [NIH] Radioactive: Giving off radiation. [NIH] Radiological: Pertaining to radiodiagnostic and radiotherapeutic procedures, and interventional radiology or other planning and guiding medical radiology. [NIH] Radiology: A specialty concerned with the use of x-ray and other forms of radiant energy in the diagnosis and treatment of disease. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Red Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral mesencephalic tegmentum. It receives a large projection from the contralateral half of the cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflex: An involuntary movement or exercise of function in a part, excited in response to a stimulus applied to the periphery and transmitted to the brain or spinal cord. [NIH] Reliability: Used technically, in a statistical sense, of consistency of a test with itself, i. e. the extent to which we can assume that it will yield the same result if repeated a second time. [NIH]

Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinoblastoma: An eye cancer that most often occurs in children younger than 5 years. It occurs in hereditary and nonhereditary (sporadic) forms. [NIH]

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Retrospective: Looking back at events that have already taken place. [NIH] Ribosome: A granule of protein and RNA, synthesized in the nucleolus and found in the cytoplasm of cells. Ribosomes are the main sites of protein synthesis. Messenger RNA attaches to them and there receives molecules of transfer RNA bearing amino acids. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Rod: A reception for vision, located in the retina. [NIH] Sagittal: The line of direction passing through the body from back to front, or any vertical plane parallel to the medial plane of the body and inclusive of that plane; often restricted to the medial plane, the plane of the sagittal suture. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Sarcoma: A connective tissue neoplasm formed by proliferation of mesodermal cells; it is usually highly malignant. [NIH] Scans: Pictures of structures inside the body. Scans often used in diagnosing, staging, and monitoring disease include liver scans, bone scans, and computed tomography (CT) or computerized axial tomography (CAT) scans and magnetic resonance imaging (MRI) scans. In liver scanning and bone scanning, radioactive substances that are injected into the bloodstream collect in these organs. A scanner that detects the radiation is used to create pictures. In CT scanning, an x-ray machine linked to a computer is used to produce detailed pictures of organs inside the body. MRI scans use a large magnet connected to a computer to create pictures of areas inside the body. [NIH] Sciatica: A condition characterized by pain radiating from the back into the buttock and posterior/lateral aspects of the leg. Sciatica may be a manifestation of sciatic neuropathy; radiculopathy (involving the L4, L5, S1 or S2 spinal nerve roots; often associated with intervertebral disk displacement); or lesions of the cauda equina. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Scoliosis: A lateral curvature of the spine. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Segmental: Describing or pertaining to a structure which is repeated in similar form in successive segments of an organism, or which is undergoing segmentation. [NIH] Segmentation: The process by which muscles in the intestines move food and wastes through the body. [NIH] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Self Care: Performance of activities or tasks traditionally performed by professional health care providers. The concept includes care of oneself or one's family and friends. [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Sex Behavior: Sexual activities of humans. [NIH]

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Sex Behavior, Animal: Sexual activities of animals. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Sex Determination: The biological characteristics which distinguish human beings as female or male. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Spina bifida: A defect in development of the vertebral column in which there is a central deficiency of the vertebral lamina. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spinal Nerve Roots: The paired bundles of nerve fibers entering and leaving the spinal cord at each segment. The dorsal and ventral nerve roots join to form the mixed segmental spinal nerves. The dorsal roots are generally afferent, formed by the central projections of the spinal (dorsal root) ganglia sensory cells, and the ventral roots efferent, comprising the axons of spinal motor and autonomic preganglionic neurons. There are, however, some exceptions to this afferent/efferent rule. [NIH] Spinal Stenosis: Narrowing of the spinal canal. [NIH] Spinous: Like a spine or thorn in shape; having spines. [NIH] Splint: A rigid appliance used for the immobilization of a part or for the correction of deformity. [NIH] Spondylitis: Inflammation of the vertebrae. [EU] Spondylolisthesis: Forward displacement of one vertebra over another. [NIH]

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Spondylolysis: Dissolution of a vertebra, especially the pars interarticularis. [NIH] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Sprains and Strains: A collective term for muscle and ligament injuries without dislocation or fracture. A sprain is a joint injury in which some of the fibers of a supporting ligament are ruptured but the continuity of the ligament remains intact. A strain is an overstretching or overexertion of some part of the musculature. [NIH] Stabilization: The creation of a stable state. [EU] Stabilizer: A device for maintaining constant X-ray tube voltage or current. [NIH] Staging: Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. [NIH]

Stenosis: Narrowing or stricture of a duct or canal. [EU] Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stricture: The abnormal narrowing of a body opening. Also called stenosis. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Surgical Instruments: Hand-held tools or implements used by health professionals for the performance of surgical tasks. [NIH] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Synovial: Of pertaining to, or secreting synovia. [EU] Synovial Membrane: The inner membrane of a joint capsule surrounding a freely movable joint. It is loosely attached to the external fibrous capsule and secretes synovial fluid. [NIH] Systemic: Affecting the entire body. [NIH] Telangiectasia: The permanent enlargement of blood vessels, causing redness in the skin or mucous membranes. [NIH] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH] Thalamic Diseases: Disorders of the centrally located thalamus, which integrates a wide range of cortical and subcortical information. Manifestations include sensory loss, movement disorders; ataxia, pain syndromes, visual disorders, a variety of neuropsychological conditions, and coma. Relatively common etiologies include

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cerebrovascular disorders; craniocerebral trauma; brain neoplasms; brain hypoxia; intracranial hemorrhages; and infectious processes. [NIH] Thoracic: Having to do with the chest. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Tic: An involuntary compulsive, repetitive, stereotyped movement, resembling a purposeful movement because it is coordinated and involves muscles in their normal synergistic relationships; tics usually involve the face and shoulders. [EU] Tin: A trace element that is required in bone formation. It has the atomic symbol Sn, atomic number 50, and atomic weight 118.71. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Translational: The cleavage of signal sequence that directs the passage of the protein through a cell or organelle membrane. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, practicability, etc., of these interventions in individual cases or series. [NIH]

Tremor: Cyclical movement of a body part that can represent either a physiologic process or a manifestation of disease. Intention or action tremor, a common manifestation of cerebellar diseases, is aggravated by movement. In contrast, resting tremor is maximal when there is no attempt at voluntary movement, and occurs as a relatively frequent manifestation of Parkinson disease. [NIH] Tropism: Directed movements and orientations found in plants, such as the turning of the sunflower to face the sun. [NIH] Tuberous Sclerosis: A rare congenital disease in which the essential pathology is the appearance of multiple tumors in the cerebrum and in other organs, such as the heart or kidneys. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the

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"personal unconscious". [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Venous: Of or pertaining to the veins. [EU] Venter: Belly. [NIH] Ventral: 1. Pertaining to the belly or to any venter. 2. Denoting a position more toward the belly surface than some other object of reference; same as anterior in human anatomy. [EU] Vertebrae: A bony unit of the segmented spinal column. [NIH] Vertebral: Of or pertaining to a vertebra. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH]

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INDEX A Ablation, 35, 95 Activities of Daily Living, 6, 95 Adjustment, 4, 95 Adolescence, 8, 68, 95 Aerobic, 3, 95 Aerobic Exercise, 3, 95 Alum, 32, 95 Aluminum, 95 Amino acid, 95, 111, 114 Ampulla, 95, 100 Anal, 5, 95, 101 Analgesic, 83, 95 Anatomical, 6, 40, 95, 98, 103, 111 Anemia, 79, 95 Anesthesia, 95, 100 Anomalies, 68, 95 Antibody, 95, 96, 103 Antigen, 95, 96, 103 Anus, 95, 96, 97, 99 Aqueous, 96, 100 Arterial, 96, 109 Arteries, 96, 97, 99, 106 Arthroplasty, 64, 65, 96 Articular, 96, 104, 107 Aseptic, 96, 100 Asymptomatic, 28, 96 Ataxia, 78, 79, 96, 98, 113 Atrophy, 78, 96 Autonomic, 35, 96, 112 Autonomic Dysreflexia, 35, 96 B Back Pain, 4, 5, 6, 7, 21, 40, 55, 65, 68, 69, 96 Basal cell carcinoma, 14, 96 Basal cells, 96 Basal Ganglia, 96 Basal Ganglia Diseases, 96 Base, 60, 96, 104 Benign, 68, 97, 104, 107 Bifida, 97 Bilateral, 10, 13, 42, 62, 97, 108 Biochemical, 12, 97, 107 Biomechanics, 6, 12, 97 Bladder, 97, 99, 101, 107, 109, 115 Blood vessel, 97, 98, 104, 112, 113, 114, 115 Bone scan, 97, 111 Bowel, 95, 97, 100, 113

Bowel Movement, 97, 100, 113 Brace, 12, 82, 97 Branch, 91, 97, 108, 112 Breakdown, 68, 97 C Capsules, 64, 97 Carbon Dioxide, 97, 101 Carcinogens, 97, 107 Carcinoma, 97 Cardiopulmonary, 35, 97 Cardiorespiratory, 95, 97 Case report, 10, 13, 14, 18, 20, 21, 26, 27, 35, 38, 45, 48, 97, 98 Case series, 97, 98 Cauda Equina, 69, 97, 111 Caudal, 97, 99, 109 Cell, 78, 79, 96, 97, 98, 103, 105, 106, 107, 109, 113, 114 Cell Division, 78, 98, 109 Cerebellar, 96, 98, 110, 114 Cerebellar Diseases, 96, 98, 114 Cerebral, 27, 96, 98 Cerebral Cortex, 96, 98 Cerebral Palsy, 27, 98 Cerebrum, 98, 114 Cervical, 61, 63, 64, 69 Cervix, 98, 101 Character, 98, 99, 110 Chin, 98, 105 Chronic, 22, 28, 40, 65, 69, 78, 96, 98, 100, 103, 104, 105, 109, 113 Chronic renal, 98, 109 Chymopapain, 98, 100 Claudication, 31, 98 Clinical study, 8, 98 Clinical trial, 4, 5, 55, 56, 75, 98, 99, 110 Cofactor, 98, 109 Collapse, 97, 98 Colon, 78, 98, 104 Compliance, 35, 99 Computational Biology, 75, 77, 99 Computed tomography, 16, 99, 111 Concomitant, 16, 35, 99 Connective Tissue, 99, 101, 102, 105, 111 Consciousness, 95, 99 Constitutional, 69, 99 Contraindications, ii, 99 Contralateral, 26, 99, 110

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Control group, 6, 99 Coronary, 99, 106 Coronary Thrombosis, 99, 106 Criterion, 48, 99 D Decompression, 10, 17, 18, 26, 29, 32, 33, 37, 39, 41, 43, 44, 99 Degenerative, 4, 5, 7, 55, 64, 65, 69, 82, 83 Diagnosis, Differential, 69, 99 Diagnostic procedure, 59, 99 Diencephalon, 99, 108 Digestive system, 56, 100 Direct, iii, 19, 100, 110 Discitis, 16, 45, 100 Diskectomy, 62, 100 Dorsal, 60, 62, 100, 109, 112 Duct, 95, 100, 111, 113 Duodenum, 100, 113 Dysplasia, 35, 79, 100 Dystrophy, 78, 100 E Efficacy, 21, 100, 114 Elective, 5, 100 Emulsion, 100, 101 Endoscope, 100 Endoscopic, 32, 100 End-stage renal, 98, 100, 109 Environmental Exposure, 100, 107 Environmental Health, 74, 76, 101 Epidermis, 96, 101 Epidural, 21, 100, 101 Erythrocytes, 95, 101 Esophagus, 100, 101, 113 Essential Tremor, 78, 101 Extremity, 101, 108 F Family Planning, 75, 101 Fat, 101, 104, 112 Femur, 27, 101 Fibrosis, 79, 101, 111 Fixation, 10, 11, 15, 19, 20, 33, 38, 39, 40, 43, 47, 48, 49, 60, 62, 63, 64, 101 Flexion, 18, 21, 43, 61, 64, 101, 104 Foramen, 98, 101, 102 Fovea, 101 Fundus, 101 G Gait, 33, 82, 98, 102 Gallbladder, 100, 101, 102 Ganglia, 96, 102, 107, 112 Gene, 68, 79, 80, 102, 107 Genetics, 23, 82, 102

Gland, 102, 105, 108, 109, 113 Glucose, 78, 102 Governing Board, 102, 109 Grade, 12, 15, 16, 17, 20, 22, 23, 24, 25, 26, 30, 33, 34, 39, 40, 42, 43, 44, 46, 48, 49, 102 Graft, 34, 39, 44, 102 Grafting, 11, 19, 33, 102 Growth, 78, 95, 102, 105, 106, 107, 109 H Health Status, 4, 102 Hemoglobin, 95, 101, 102 Hemoglobinuria, 78, 102 Hemorrhage, 102, 113 Hereditary, 25, 102, 110 Heredity, 102 Herniated, 4, 5, 15, 68, 69, 102 Hormonal, 96, 103 Hydrogen, 96, 103, 106 I Id, 52, 78, 83, 84, 90, 92, 103 Idiopathic, 18, 69, 103 Immune adjuvant, 95, 103 Immune response, 95, 96, 103 Immunodeficiency, 78, 103 Impairment, 96, 103, 105 In situ, 11, 13, 26, 27, 29, 33, 44, 46, 103 In vitro, 12, 15, 103 In vivo, 103 Indicative, 67, 103, 108, 115 Infarction, 99, 103, 106 Infection, 62, 68, 96, 100, 103, 105, 107, 113 Inflammation, 100, 101, 103, 109, 112 Infusion, 3, 103 Intermittent, 35, 103, 104 Intermittent Claudication, 35, 103 Intervertebral, 5, 12, 19, 28, 38, 42, 62, 68, 100, 102, 103, 105, 111 Intervertebral Disk Displacement, 103, 105, 111 Intestinal, 103, 105 Intracellular, 103 Intravenous, 103, 104 Invasive, 104, 105 Involuntary, 96, 101, 104, 106, 110, 114 Ions, 96, 103, 104 Ischemia, 96, 104 Isometric Contraction, 6, 104 J Joint, 64, 65 Joint Capsule, 64, 104, 113

119

K Kb, 74, 104 Kidney Disease, 56, 74, 79, 104 Kyphosis, 68, 104 L Large Intestine, 100, 104, 110 Leukemia, 78, 104 Library Services, 90, 104 Ligament, 104, 109, 113 Lipoma, 21, 104 Liver, 100, 102, 104, 111 Liver scan, 104, 111 Localized, 69, 101, 103, 104, 106, 109 Long-Term Care, 7, 104 Lordosis, 39, 48, 68, 93, 104 Lordotic, 64, 104 Low Back Pain, 4, 5, 8, 22, 28, 55, 69, 105 Lumbar, 6, 7, 55, 60, 61, 63, 64, 68, 69, 82 Lumbar puncture, 100, 105 Lymph, 98, 105 Lymph node, 98, 105 Lymphatic, 103, 105 Lymphoid, 105 Lymphoma, 78, 105 Lytic, 30, 31, 33, 46, 83, 105 M Magnetic Resonance Imaging, 39, 105, 111 Malabsorption, 78, 105 Malignant, 68, 78, 105, 107, 111 Malnutrition, 96, 105, 106 Medial, 24, 105, 111 MEDLINE, 75, 77, 79, 105 Melanocytes, 105 Melanoma, 78, 105 Membrane, 105, 110, 113, 114 Mental, iv, 4, 57, 74, 76, 80, 98, 105, 110 Mental Disorders, 57, 105, 110 Meta-Analysis, 18, 105 Metastasis, 106 Metastatic, 69, 106 MI, 94, 106 Mobility, 28, 106 Modeling, 6, 106 Modification, 95, 106, 110 Molecular, 75, 77, 99, 106 Molecule, 96, 106 Morphology, 21, 106 Muscle Fibers, 106 Muscular Atrophy, 78, 106 Muscular Dystrophies, 100, 106 Myelography, 34, 100, 106 Myocardium, 106

Myotonic Dystrophy, 78, 106 N NCI, 1, 56, 73, 106 Neck Pain, 69, 106 Need, 3, 34, 68, 85, 95, 98, 106 Neoplasia, 78, 106, 107 Neoplasm, 107, 111 Neoplastic, 105, 107 Nephropathy, 104, 107 Nerve, 11, 21, 27, 29, 31, 35, 55, 62, 82, 83, 95, 96, 97, 98, 102, 107, 111, 112, 113 Nervous System, 78, 96, 102, 107, 108 Neural, 15, 35, 107 Neurogenic, 31, 35, 107 Neurologic, 69, 107 Neuromuscular, 6, 107 Neuropathy, 107, 111 Neurosyphilis, 107, 108 Nitrogen, 101, 107 Nuclei, 105, 107 Nucleus, 69, 96, 103, 107, 110, 113 O Oncogene, 78, 107 Ophthalmology, 101, 107 Optic cup, 107, 108 Optic Nerve, 107, 108, 110 Orthotic Devices, 70, 107 Osteoarthritis, 69, 107 Osteoporosis, 68, 107 P Palpation, 69, 108 Pancreas, 100, 108 Pancreatic, 78, 108 Pancreatic cancer, 78, 108 Paralysis, 108 Paraparesis, 108 Paresis, 27, 108 Paroxysmal, 78, 108 Pathogenesis, 34, 39, 47, 108 Pathologic, 14, 99, 108 Pathologies, 64, 65, 108 Patient Education, 82, 83, 88, 90, 94, 108 Patient Satisfaction, 4, 108 Pedicle, 10, 12, 15, 33, 34, 36, 39, 43, 44, 45, 48, 49, 108 Pelvic, 17, 39, 48, 108, 109 Pelvis, 60, 105, 108, 115 Percutaneous, 100, 108 Perforation, 15, 101, 108 Phallic, 101, 108 Pharmacologic, 95, 108, 114 Physical Examination, 68, 83, 108

120

Spondylolisthesis

Physical Therapy, 3, 6, 82, 83, 108 Physiologic, 109, 114 Plants, 97, 102, 106, 109, 114 Pneumonia, 99, 109 Polycystic, 79, 109 Posterior, 61, 62, 64 Postmenopausal, 107, 109 Postoperative, 25, 33, 38, 109 Practicability, 109, 114 Practice Guidelines, 76, 83, 109 Preoperative, 25, 41, 109 Prevalence, 47, 109 Progression, 10, 16, 41, 109 Progressive, 98, 102, 106, 107, 109 Promoter, 100, 109 Prospective study, 7, 18, 23, 31, 36, 41, 109 Prostate, 78, 109 Protein S, 68, 79, 109, 111 Protocol, 6, 110 Psychiatry, 101, 110 Psychic, 105, 110, 111 Public Policy, 75, 110 Pulposus, 69, 103, 110 Q Quality of Life, 5, 110 R Race, 110 Radiation, 101, 110, 111, 115 Radicular, 18, 40, 46, 110 Radioactive, 97, 103, 104, 110, 111 Radiological, 29, 40, 108, 110 Radiology, 13, 26, 34, 35, 42, 43, 50, 110 Randomized, 27, 36, 44, 46, 100, 110 Rectum, 96, 97, 98, 100, 104, 109, 110 Red Nucleus, 96, 110 Refer, 1, 101, 110 Reflex, 10, 110 Reliability, 28, 43, 110 Restoration, 108, 110 Retina, 107, 110, 111 Retinoblastoma, 78, 110 Retrospective, 31, 111 Ribosome, 111, 114 Risk factor, 109, 111 Rod, 19, 63, 111 S Sagittal, 10, 20, 21, 31, 44, 48, 64, 111 Salivary, 100, 108, 111 Salivary glands, 100, 111 Sarcoma, 22, 111 Scans, 82, 111 Sciatica, 21, 26, 28, 45, 111

Sclerosis, 78, 79, 111 Scoliosis, 7, 9, 10, 18, 25, 44, 63, 64, 68, 69, 111 Screening, 98, 111 Segmental, 6, 33, 39, 111, 112 Segmentation, 111 Seizures, 108, 111 Self Care, 95, 111 Semen, 109, 111 Senile, 108, 111 Sex Behavior, 104, 111, 112 Sex Behavior, Animal, 104, 112 Sex Characteristics, 95, 112 Sex Determination, 79, 112 Shock, 112, 114 Side effect, 112, 114 Skeletal, 13, 69, 106, 112 Skeleton, 12, 20, 69, 101, 104, 112 Social Environment, 110, 112 Soft tissue, 64, 112 Somatic, 95, 112 Specialist, 84, 112 Species, 110, 112 Spina bifida, 25, 112 Spinal cord, 55, 97, 101, 106, 107, 108, 110, 112 Spinal Nerve Roots, 111, 112 Spinal Stenosis, 4, 5, 7, 17, 18, 35, 47, 55, 64, 65, 69, 82, 112 Spinous, 64, 101, 112 Splint, 97, 112 Spondylitis, 63, 112 Spondylolysis, 3, 68, 82, 83 Sporadic, 110, 113 Sprains and Strains, 105, 113 Stabilization, 37, 40, 41, 42, 48, 64, 113 Stabilizer, 60, 113 Staging, 111, 113 Stenosis, 4, 5, 7, 31, 32, 33, 44, 55, 64, 65, 69, 82, 113 Stimulus, 110, 113 Stomach, 100, 101, 113 Stool, 98, 104, 113 Stress, 20, 26, 82, 94, 113 Stricture, 113 Stroke, 57, 74, 113 Subacute, 103, 113 Subclinical, 103, 111, 113 Surgical Instruments, 65, 113 Symphysis, 98, 109, 113 Symptomatic, 12, 28, 34, 40, 41, 113 Synergistic, 113, 114

121

Synovial, 104, 113 Synovial Membrane, 104, 113 Systemic, 69, 103, 113 T Telangiectasia, 79, 113 Thalamic, 96, 113 Thalamic Diseases, 96, 113 Thoracic, 69, 96, 114 Thorax, 105, 114 Thrombosis, 109, 113, 114 Tic, 5, 114 Tin, 83, 114 Tissue, 62, 64, 96, 97, 99, 102, 104, 105, 106, 107, 108, 109, 110, 112, 114 Tomography, 16, 99, 111, 114 Toxic, iv, 101, 107, 114 Toxicology, 76, 114 Toxins, 96, 103, 114 Trace element, 114 Translation, 21, 61, 64, 95, 114 Translational, 64, 114 Trauma, 8, 20, 24, 38, 43, 44, 46, 68, 69, 96, 114 Treatment Outcome, 70, 114

Tremor, 78, 114 Tropism, 22, 37, 114 Tuberous Sclerosis, 79, 114 U Unconscious, 96, 103, 114 Urethra, 109, 115 Urine, 97, 102, 115 Uterus, 98, 101, 115 V Vaccine, 95, 110, 115 Vascular, 103, 115 Venous, 109, 115 Venter, 115 Ventral, 61, 112, 115 Vertebrae, 16, 48, 60, 61, 62, 63, 64, 83, 103, 112, 115 Vertebral, 26, 48, 50, 60, 64, 82, 97, 100, 112, 115 Veterinary Medicine, 75, 115 Visceral, 69, 115 Vitro, 115 X X-ray, 82, 94, 99, 106, 110, 111, 113, 115

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