Spondylolisthesis is a condition of the spine in which one of the vertebrae slips forward or backward and onto the bone underneath. Although it can happen anywhere along the spine, it most commonly occurs in the lumbar region, or the lower back. In severe cases if left without proper treatment, permanent spine deformity and stenosis can occur, which can lead to permanent damage and chronic pain. There are different types of spondylolisthesis. The most common include:
- Degenerative spondylolisthesis (normal wear and tear from aging)
- Congenital spondylolisthesis (abnormal spine formation present at birth)
- Spondylolytic spondylolisthesis (stress fracture from injury)
The spine consists of 24 vertebrae along the back that protect the spinal cord. In medical terminology, it is divided into regions that correspond to their position along the spinal cord as follows:
- Cervical vertebrae in the neck (C1-C7)
- Thoracic vertebrae in the upper back (T1-T12)
- Lumbar vertebrae in the lower back (L1-L5)
- Sacral vertebrae in the pelvic region (S1-S5)
Lower back pain, particularly after exercise or activity, is the most commonly reported symptom of spondylolisthesis. Other common symptoms include:
- Decreased range of motion in lower back
- Numbness, tingling and/or weakness in the legs
- Tight hamstrings and buttock muscles that may lead to muscle spasms
The spine specialists at Mischer Neuroscience Associates utilize a variety of the most state-of-the-art equipment to diagnose spondylolisthesis, with advanced technology that can help locate the precise area where pain is occurring and why. Diagnostic tests may include:
Treatment of spondylolisthesis depends upon a variety of factors, and most often, patients can be successfully treated without surgery. Spondylolisthesis is diagnosed by severity as Grades I–IV according to the degree of slippage, with Grade I being the most moderate and IV being the most severe.
For those with Grades I and II spondylolisthesis, treatment usually involves rest followed by a physical therapy regimen to strengthen the back muscles. Non-steroidal anti-inflammatory drugs (NSAIDs) may help relieve pain, and low doses of prescription medications may help some patients whose pain interferes with daily activities. Wearing a back brace may also be recommended.
More severe spondylolisthesis diagnosed as Grades III and IV may require surgical intervention if the vertebra continues to slip, if there is nerve compression, or if conservative treatment methods are ineffective.
Causes of Spondylolisthesis
Degenerative spondylolisthesis is the most common form of the disorder, and is caused by aging and the natural wear and tear on the disks of the spine. The disks in between the vertebrae act as cushions, and as we age, they dry out and lose their ability to work as the spine’s natural shock absorbers. As the disk cartilage degenerates, a vertebra can slip forward or backward onto an adjacent vertebra.
Less commonly, spondylolisthesis is caused by a condition present at birth. People who play sports such as football, gymnastics or those who engage in heavy weight lifting can be more susceptible to spondylolisthesis because of the strain and stress these activities can have on the lower back during extension.
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