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Spondylolisthesis
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WHAT IS SPONDYLOLISTHESIS?
Spondylolisthesis is a type of spinal condition. It occurs when one of the bones in your spine – the vertebrae – moves out of place and slips forward onto the bone below.
There are three main types of spondylolisthesis:
• Degenerative spondylolisthesis: As we get older, the discs between the vertebrae become thinner and less strong, which may cause the bones to slip out of place.
• Congenital spondylolisthesis: This type of spondylolisthesis is acquired before birth. The spine doesn’t form correctly which leaves the bones prone to slippage.
• Isthmic spondylolisthesis: Occurs after a fracture or crack weakens the bone.
SPONDYLOLISTHESIS vs. SPONDYLOSIS
Spondylolisthesis is when the bones slip out of place. Spondylosis occurs when there’s arthritis in the spine which causes the cartilage to wear down. This can cause lower back pain and leg numbness when walking/standing.
Spondylolisthesis is not the same as spondylolysis, either, which occurs when there’s a small fracture or crack in the vertebrae. Both conditions, however, can cause back pain, and spondylolysis may lead to isthmic spondylolisthesis.
SPONDYLOLISTHESIS CAUSES
Spondylolisthesis causes include:
• Age
• Frequently overextending the spine
• Sports such as gymnastics and weightlifting
A birth defect or injury can also cause spondylolisthesis.
Is spondylolisthesis genetic? Possibly – if you’re born with weaker or thinner vertebrae, you may be more prone to spondylolisthesis in the future. -
SPONDYLOLISTHESIS SYMPTOMS
Spondylolisthesis is not always easy to diagnose. As with many spinal conditions, one of the most common spondylolisthesis symptoms is lower back pain which can extend into the buttocks or thighs. Other spondylolisthesis symptoms you may notice include:
• Back muscle stiffness, tightness, or spasms
• Difficulty standing or walking for long periods of time
• Pain which radiates down one or both legs
• Back or leg pain when bending over
• Numbness, weakness, or tingling in the foot
• Tight hamstrings
When pain spreads down the leg, or there’s numbness, weakness, or tingling in the leg or foot, this could indicate nerve compression or irritation caused by the slipped bone.
WHAT DOES SPONDYLOLISTHESIS PAIN FEEL LIKE?
Every patient experiences spondylolisthesis pain differently. For example, some patients may have no pain at all, whereas others may have very severe pain which disrupts daily life.
Spondylolisthesis pain can often feel like pain caused by other back conditions such as disc herniations, so it’s crucial you receive a formal diagnosis to receive the right care. -
SPONDYLOLISTHESIS DIAGNOSIS
Your specialist may suspect spondylolisthesis after you describe your symptoms and they perform a physical exam. However, the condition should be formally diagnosed by using imaging techniques such as:
• MRI
• X-ray
• CT scan
These scans can show if there’s a spinal bone out of alignment, and how far the bone has shifted forward. An x-ray may be used to first determine if there’s a misaligned bone, and a CT or MRI scan can show whether the bone is affecting surrounding soft tissues and structures like nerves and intervertebral discs.
GRADES OF SPONDYLOLISTHESIS
As part of the diagnostic process, the specialist will determine whether the spondylolisthesis is “low-grade” or “high-grade”. The grading plays a part in deciding how to treat your condition.
• Grade I and Grade II: Low-grade spondylolisthesis occurs when 50% or less of the bone has shifted forward.
• Grade III and Grade IV: High-grade spondylolisthesis is diagnosed when more than 50% of the bone has slipped forward – this is more likely to require surgery to correct at some stage.
• Grade V: This is when the entire bone falls forward. It’s generally only seen after very traumatic or high-impact injuries and can cause severe spinal cord damage.
IS SPONDYLOLISTHESIS A SERIOUS CONDITION?
Spondylolisthesis is not a life-threatening condition and it’s usually not serious. However, it’s important you talk to your healthcare provider or a spondylolisthesis specialist if you think you have spondylolisthesis – early treatment can improve your overall quality of life and make you feel more comfortable.
Although spondylolisthesis is rarely serious, seek medical attention if you develop:
• A sudden increase in back pain
• Loss of feeling in one or both legs
• Changes in bladder and/or bowel function
• Sensory changes e.g. numbness or pins and needles in the groin, inner thigh, genital or buttock area
These symptoms may indicate nerve compression which requires urgent treatment. -
SPONDYLOLISTHESIS TREATMENT OPTIONS
Spondylolisthesis treatment depends on the degree of slippage and the symptoms you have.
Unless you have a high degree slip or very severe symptoms, non-surgical treatment is the preferred approach. Non-surgical options include:
• Physical therapy: Spondylolisthesis exercises can strengthen the core and back muscles.
• Rest: Some patients benefit from taking a break from strenuous activity.
• Medication: Steroid injections and over-the-counter anti-inflammatory drugs may help.
• Bracing: For children, a brace can help stabilize the spine.
Surgery such as a spinal fusion is indicated if non-surgical treatment fails or there’s a clinical need
SPONDYLOLISTHESIS OUTLOOK
Spondylolisthesis won’t go away on its own, but it can be successfully managed. The best spondylolisthesis doctors will work with you to design an effective treatment plan to help you feel better – contact our spondylolisthesis specialists now to find out more about the treatment options available.