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Spondylolisthesis w/ Scoliosis



- Discussion:
    - scoliosis is present in > 20% pts who have symptomatic spondylolisthesis but in only 13 per cent of those who have spondylolysis;
    - incidence of scoliosis is higher in pts w/ dysplastic spondylolisthesis than in those who have isthmic spondylolisthesis;

- Olisthetic scoliosis:
    - scoliosis usually is not structural & is second to lumbar muscle spasm;
           - curves will resolve w/ recumbency and relief of symptoms;
    - olisthetic scoliosis is a torsional lumbar curve, w/ asymmetrical displacement & rotation that begins at the spondylolytic defect;
    - about two-thirds of lumbar and olisthetic curves can be expected to resolve after surgical stabilization of the spondylolisthesis, and those 
         that do not improve seldom progress;

- Idiopathic Scoliosis:
    - idiopathic curves are confined to thoracic or thoracolumbar portion of spine and develop in about 1/3 of patients who have 
          Spondylolisthesis;
    - the question in these patients is whether the fusion should be carried down to S1