Medication Summary
The goal of medication in care of spondylolysis or spondylolisthesis of any type is to mitigate pain. NSAIDs are used most commonly while narcotic analgesics are used for breakthrough pain.
Nonsteroidal anti-inflammatory medications
Class Summary
Have analgesic, anti-inflammatory, and antipyretic activities. Their mechanism of action is not known, but may inhibit cyclo-oxygenase activity and prostaglandin synthesis. Other mechanisms may exist as well, such as inhibition of leukotriene synthesis, lysosomal enzyme release, lipoxygenase activity, neutrophil aggregation, and various cell membrane functions.
Ibuprofen (Ibuprin, Motrin)
DOC for patients with mild to moderate pain. Inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis.
Naproxen (Naprosyn, Naprelan, Anaprox, Aleve)
For relief of mild to moderate pain; inhibits inflammatory reactions and pain by decreasing activity of cyclo-oxygenase, which results in a decrease of prostaglandin synthesis.
Etodolac (Lodine, Lodine XL)
Inhibits prostaglandin synthesis by decreasing activity of the enzyme, cyclo-oxygenase, which results in decreased formation of prostaglandin precursors, which in turn results in reduced inflammation.
Sulindac (Clinoril)
Decreases activity of cyclo-oxygenase and in turn inhibits prostaglandin synthesis. Results in a decreased formation of inflammatory mediators.
Analgesics
Class Summary
Pain control is essential to quality patient care. Analgesics ensure patient comfort and have sedating properties, which are beneficial for patients who experience pain.
Acetaminophen (Tylenol, Feverall, Tempra, Aspirin Free Anacin)
DOC for pain in patients with documented hypersensitivity to aspirin or NSAIDs, with upper GI disease, or who are taking oral anticoagulants.
Hydrocodone and acetaminophen (Vicodin, Lortab, Norcet, Lorcet-HD)
Drug combination indicated for moderate to severe pain.
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Radiograph of the lumbosacral junction showing a grade 1 spondylolytic spondylolisthesis at L5-S1.
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Lumbar oblique radiograph showing the "Scottie Dog." A pars defect is seen at L5.
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Bone scan with single-photon emission computed tomography (SPECT) imaging showing acute spondylolysis
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Axial computed tomography (CT) scan shows bilateral spondylolysis. Note elongation of the spinal canal at this level.
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Grade 4 traumatic spondylolisthesis.
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Diagram in the oblique projection shows the components of the vertebrae that result in the appearance of a Scottie dog with a collar.
