What is Spondylolisthesis?
Spondylolisthesis is a condition in which one of the bones of the spine (vertebrae) slips out of place onto the vertebra below it. If it slips too much, the bone might press on a nerve, causing pain. Usually, the bones of the lower back are affected.
The word spondylolisthesis comes from the Greek words spondylos, which means “spine” or “vertebra,” and listhesis, which means “to slip or slide.”
What are the symptoms of Spondylolisthesis?
There are no direct symptoms associated with this medical state, Spondylolisthesis. The symptoms are so generalised that many people who have this condition do not even know it. Moreover, the people knowing that they have this issue do not find them selves ill or suffering.
However, the patient having spondylolisthesis may occasionally suffer from walking abnormalities. He/she may complain of constant pain is lower back. Pain in leg is also very common in the people with this condition. Such muscle pain exaggerates with the physical activity and mellows down on taking rest. If the problem becomes severe, the patient might face postural abnormalities
What are the causes of Spondylolisthesis?
There are 3 types of Spondylolisthesis and are also the causes of Spondylolisthesis:
- Congenital spondylolisthesis — Congenital means “present at birth.” Congenital spondylolisthesis is the result of abnormal bone formation. In this case, the abnormal arrangement of the vertebrae puts them at greater risk for slipping.
- Isthmic spondylolisthesis — This type occurs as the result of spondylolysis, a condition that leads to small stress fractures (breaks) in the vertebrae. In some cases, the fractures weaken the bone so much that it slips out of place.
- Degenerative spondylolisthesis — This is the most common form of the disorder. With aging, the discs — the cushions between the vertebral bones — lose water, becoming less spongy and less able to resist movement by the vertebrae. The body becomes vulnerable to this condition with the growing age. As the person grow old, his bones become week and hence more susceptible to the injuries.
- If the person is actively engaged in sports like gymnastics, weight lifting, soccer, he/she is quite vulnerable to this condition. Such sports involve hyperextension of the spine and thus put it at the risk of spondylolisthesis.
- There is a condition when the new bones begin to grow. They work like the pars heals. As a result, the pars begin to stretch. Thus the elongated pars push the vertebra forward resulting in this condition.
How is Spondylolisthesis diagnosed?
Spondylolisthesis is easily identified using plain radiographs. A lateral X-ray (from the side) will show if one of the vertebra has slipped forward compared to the adjacent vertebrae. Spondylolisthesis is graded according the percentage of slip of the vertebra compared to the neighboring vertebra.
- Grade I is a slip of up to 25%,
- grade II is between 26%-50%,
- grade III is between 51%-75%,
- grade IV is between 76% and 100%, and
- Grade V, or spondyloptosis occurs when the vertebra has completely fallen off the next vertebra.
If the patient has complaints of pain, numbness, tingling or weakness in the legs, additional studies may be ordered. These symptoms could be caused by stenosis or narrowing of the space for the nerve roots to the legs. A CT scan or MRI Scan can help identify compression of the nerves associated with spondylolisthesis.
What are the treatments for Spondylolisthesis?
- Oral Medications: pain relief and anti-inflammatory medications
- Anti-inflammatory injection
- Epidural Injection
- Physical therapy — Stabilization exercises are the mainstay of treatment. These exercises strengthen the abdominal and/or back muscles, minimizing bony movement of the spine. Generally, eight to 12 weeks of aggressive daily treatment with stabilization exercises are needed to achieve clinical improvement.
- Back Brace – Patients with isthmic spondylolisthesis may benefit from a hyperextension brace. This extends the lumbar spine bringing the two portions of the bone at the defect closer together and may allow for healing to occur.
- Surgery — Surgery might be necessary if the vertebra continues to slip or if the pain is not relieved by conservative treatment and begins to interfere with daily activities. The main goals of surgery for spondylolisthesis are to relieve the pain associated with an irritated nerve, to stabilize the spine where the vertebra has slipped out of place, and to increase the person’s ability to function.
Can spondylolisthesis be prevented?
Although spondylolisthesis might not be preventable, there are steps you can take to reduce the risk of slips:
- Keep your back and abdominal muscles strong to help support and stabilize the lower back.
- Choose activities and sports that do not place your lower back at risk for injury. Swimming and biking are possible options.
- Maintain a healthy weight. Excess weight puts added stress on your lower back.
- Eat a well-balanced diet to keep your bones well-nourished and strong.