Spondylolisthesis

Spondylolisthesis

Spondylolisthesis is a condition of the spine, which occurs when vertebrae move more than it should, and eventually slips out of their place. Generally, it happens at the base of the spine. The slipped vertebra puts pressure on one of your nerves, which causes pain in the lower back or legs.

Symptoms

In some cases, people having spondylolisthesis may not notice anything wrong or unusual. Some of the symptoms may include:

  • Lower back pain
  • Pain in the buttocks
  • Pain spreading down the legs, due to the pressure on the nerve roots
  • Trouble standing or walking
  • Muscle tightness and stiffness
  • Pain that gets worse during activity
  • Tight hamstrings

Causes & risk factors

Generally, spondylolisthesis is of six main types. The cause determines the type of spondylolisthesis you are having. The types include:

  • Congenital spondylolisthesis- In this type, a vertebra is defective from the time of a person’s birth.
  • Isthmicspondylolisthesis- This type of spondylolisthesis is caused by another condition which is known as spondylolysis, where a fracture, or crack, in the thin part of your vertebra can cause the vertebrae to slip backward, forward, or over a bone below.
  • Traumatic spondylolisthesis- An injury or a trauma can also sometimes cause a vertebra to slip out of place.
  • Degenerative spondylolisthesis- Over the course of time, the discs that cushion the vertebrae dry out and become thinner. This thinning can make the lead a vertebra to slip out of place.
  • Post-surgical spondylolisthesis- Sometimes a vertebra may slip out of place after spinal surgery.
    Pathological spondylolisthesis- Sometimes, a different condition such as osteoporosis or cancer can also lead to spondylolisthesis.

 

You are more likely to have this condition if you are an athlete. It’s known to be quite common in kids who are into gymnastics or football.

If you were born with thinner areas of vertebrae, that are prone to slipping or breaking, it makes you more likely to develop it as well. Old age or having a degenerative spinal condition are also factors that make you more likely to develop this condition.

Diagnosis

The first step to diagnose this condition is a physical examination. If you are having spondylolisthesis, then you might experience difficulty raising your leg straight outward while you are performing a simple exercise.

To determine whether a vertebra is out of place, an X-ray is crucial. It is also likely that your doctor is going to look for any possible fractures in the bone on the X-ray images. If the misplaced bone is pressing on your nerves, then your doctor might order a more detailed X-ray.

Treatments

The treatments for this condition can vary, depending on the severity of the pain and vertebrae slippage. Nonsurgical treatments can help in easing the pain and encourage the bone to go back into place. During the healing process, it is also important to avoid contact sports.

Non-surgical treatments

Some of the common non-surgical treatment methods can include the following:

  • Wearing a Back Brace
  • Performing physical therapy exercises
  • Taking anti-inflammatory drugs or over-the-counter medications
  • Epidural steroids injections

Surgery

Adults who are suffering from severe cases of spondylolisthesis might need to have a surgery known as spinal fusion.

When the bone has slipped so far down, surgical correction of the misplaced vertebra is necessary, if your spine is not responding to any nonsurgical therapies. Surgery can also be required if the bones of your spine are pressing on the nerves.

In order to stabilize your spine, your doctor will use bone grafts and metal rods. He/she might insert an internal brace as well, to help in supporting the vertebra while it is healing.
After the spinal fusion is complete, it can take four to eight months for the bones to fuse fully together. Generally, the success rate of the surgery is high.

Complications

Sometimes serious spondylolisthesis can lead you to another condition which is known as cauda equina syndrome. This can be a serious condition in which the nerve roots in a part of your lower back, known as the cauda equina get compressed. This can lead you to lose sensation in your legs, and may also affect your bladder. This condition is a medical emergency, and if left untreated, it might even lead to loss of bladder control and paralysis.

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