Understanding of Disease
- Less frequently seen in children: Our understanding of degenerative lumbar disease in children is still evolving as many of our practices have been extrapolated from our understanding of lumbar degenerative disease in adults. The lower prevalence of lumbar disease in children has also limited larger studies and more child-specific data. Specific differences will be addressed in each section below.
- Imaging and surgical techniques have improved: Both improved imaging and operative techniques have contributed to advancing our management of patients with degenerative lumbar disk disease. Theoretically, advances in instrumentation and intraoperative navigation may also provide a safer operative environment.
- Minimally invasive surgical techniques: Minimally invasive approaches have been reported to decrease blood loss while maintaining similar results in pediatric patients (30). Although varyious surgical techniques for reduction and fixation of spondylolisthesis have been described, no particular development has proven superior to others. Individual practices largely reflect the surgeon’s personal preference.
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