A spinal ailment in which a vertebra has displaced and then slipped onto the vertebrae directly underneath.
What is Spondylolisthesis?
- Physical activity, wear and tear, and aging may develop spondylolisthesis, which is a slippage of a vertebra on top of another. About 6 percent of males and 3 percent of females develop this spinal condition, and may do so more than once if continued physical activity occurs.
- There are 5 grades of slippage with 1 being the smallest degree and 5 being the largest. Grade 5 is so severe that the vertebra has altogether fallen off.
- There are two types of spondylolisthesis. The first is called spondylolytic spondylolisthesis, which mainly affects younger adolescents and those who participate in a lot of physical activity. The second is called degenerative spondylolisthesis, which are more advanced forms of the condition.
- Many patients with spondylolisthesis are not aware of their condition until a nerve or the spinal cord is compressed.
What causes it?
Usually, spondylolisthesis occurs when repeated stress is put upon the body. With the lesser stage, spondylolytic spondylolisthesis, high physical activity, sudden trauma, wear and tear, or having a predisposed condition most commonly causes it. These activities commonly cause stress fractures in the vertebrae that may then allow the slippage.
Most cases of spondylolytic spondylolisthesis are undetected, but symptoms usually come and go quickly. The most common symptoms are: pain in the lower back, sciatica pain that radiates down the buttocks, legs, calves, feet, or toes, and weakness or numbing of the lower extremities.
If spondylolisthesis worsens, then the fracture may cause the vertebrae to become unstable and cause progressive slipping. This is degenerative spondylolisthesis, which mainly affects patients over 60 years old. Instability usually occurs if the condition is not properly healed or if the physical activity that initially caused the condition is continued.
The more the spinal nerve and/or spinal cord is compressed, the more severe the case of spondylolisthesis is. Sometimes patients are in so much pain that they have trouble walking or standing straight.
How do you treat it?
Since most cases of spondylolisthesis are minor, treatment usually encompasses conservative, non-surgical methods. Any physical activity that may have caused the condition is recommended to cease, and rest along with medication is taken. Physical therapy and massages are recommended for worse cases. Others may have to align their spine with a back brace, which may help with preventing continued slippage.
If pain is severe, steroidal medications such as oral pills or injections may be prescribed. However, if pain ever becomes chronically worse, or the vertebra continues to slip, then surgery such as laminectomy and/or spinal fusion may be recommended.
Laminectomy removes the vertebral disc to relieve the compression on nerve roots and/or spinal cord. Spinal fusion also removes the vertebral disc, but also replaces the disc with a bone graft to fuse the vertebrae. Metal hardware may also be attached to the vertebrae for stabilization and the prevention of repeat slippage.
If you would like more information, and you feel you may be a candidate for spinal surgery, please send us your MRI scan here and we will review it for free.