Spondylolisthesis is a condition of the spine where one of the vertebra slips out its position onto the bone below or above it. Forward slippage of an upper vertebra on a lower vertebra is referred to as anterolisthesis, while backward slippage is referred to as retrolisthesis. Spondylolisthesis can lead to a deformity of the spine as well as a narrowing of the spinal canal (spinal stenosis) or compression of the exiting nerve roots (foraminal stenosis).
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Spondylolisthesis in children usually occurs between the fifth bone in the lower back (lumbar vertebra) and the first bone in the sacrum (pelvis) area. This is often due to an injury, fracture or a birth defect in that area of the spine. In adults, aging and the abnormal wear and tear of the cartilage and bones, such as arthritis. Some sports activities that put a lot of stress on in the lower back can also cause spondylolisthesis, such as weight lifting or gymnastics. A stress in the spine can cause the spinal bone to weaken and shift out of position.
Bone disease and fractures can also cause spondylolisthesis. Certain sport activities — such as gymnastics, weight lifting, and football — put a great deal of stress on the bones in the lower back. They also require that the athlete constantly overstretch (hyperextend) the spine. This can lead to a stress fracture on one or both sides of the vertebra. A stress fracture can cause a spinal bone to become weak and shift out of place.
Spondylolisthesis may vary from mild to severe. Patients with spondylolisthesis may show or feel no symptoms. The condition can produce increased lordosis (swayback) or kyphosis (roundback) in later stages as the upper spine falls off the lower spine.
Symptoms may include:
- Lower back pain
- Pain, numbness or tingling sensation in the back of the legs, thighs and buttocks
- Muscle tightening
- Weakness in the legs
- Tenderness in the affected are of the spine
Spondylolisthesis can be detected through physical exam of the the back and the spine. You may be asked to raise your leg stratight out in front of you to check for pain or discomfort.
Special imaging studies may be needed to determine the cause of the problem.
- X-ray – To show if a bone in the spine is out of place or fractured.
Depending onthe severity of spondylolisthesis, ONE® Brain & Spine Center® may recommended a course of non-surgical treatment and oral medications. Initial treatment may include pain and anti-inflammatory medications or non-steroidal pain medication. You may be asked to avoid strenuous activities to protect your back. If the pain is severe and the non-surgical treatment does not alleviate the pain, minimally invasive decompressive surgery may be recommended.
- Pain and anti-inflammatory medications
- Back brace
- Physical therapy
Minimally Invasive Surgical Treatments
- Posterior Cervical and Lumbar Microdiscectomy (Microdecompression)- Microdiscectomy, also known as microdecompression, is one of the most commonly performed minimally invasive spine procedures. Beneficial for those with damaged discs at either the cervical or lumbar level, microdiscectomy effectively removes the pressure off the spinal nerves, relieving chronic neck and back pain without the recovery and rehabilitation time required with traditional, open discectomy spine surgery. Read more about Microdecompression.
- Anterior Lumbar Interbody Fusion (ALIF)- Spinal fusion is a procedure that “welds” two vertebrae of the spine together to create one solid bone and relieve chronic pain. The anterior approach for the lumbar fusion is through the front of the body– the abdomen– and is considered to be far more ideal than the traditional posterior approach, or through the back. Read more about ALIF.
- Posterior Cervical and Lumbar Microdiscectomy (Microdecompression) – Microdiscectomy, also known as microdecompression, is one of the most commonly performed minimally invasive spine procedures. Beneficial for those with damaged discs at either the cervical or lumbar level, microdiscectomy effectively removes the pressure off the spinal nerves, relieving chronic neck and back pain without the recovery and rehabilitation time required with traditional, open discectomy spine surgery. Read more about Microdecompression.