Akitoshi Masuda

Natural History of Degenerative Spondylolisthesis: Pathogenesis and Natural Course of the Slippage

To clarify the natural course of degenerative spondylolisthesis, the mechanism and progression of disk slippage were studied clinically and radiographically in 40 patients. Progressive slippage was observed in 12 patients (30%). No progression of slippage was noted in patients who showed narrowing of the interyertebral disk, spur formation, subcartilaginous sclerosis, or ossification of ligaments. These suggest that the mechanisms of spinal restabilization prevent progression of the disease. General joint laxity was observed in many patients (65%), and this was believed to be involved in the pathogenic mechanism of this disease. There was no correlation between the clinical symptoms and progression of slippage. These findings suggest that careful consideration of the natural mechanisms of spinal restabilization as well as the natural course of the disease is important.

Percutaneous discectomy in athletes

Percutaneous discectomy has been widely used for the lumbar disc herniation in recent years because it is a simple and safe procedure. This report evaluates the postoperative return to the original level of activity among athletes who compete in their sports on a national level. It has been thought that the recovery rate was poor in the conventional surgery but there have been few studies. The postoperative results using percutaneous discectomy were rated as excellent in 4 athletes, good in 5, poor in 4. The patients generally returned to full sports activity 2 months after surgery. The authors conclude that percutaneous discectomy may be considered if conservative treatments fail to relieve pain in athletes.