Spondylolisthesis: Symptoms, Causes and Treatment

Overview

Spondylolisthesis is a slipping of vertebra that occurs generally at the base of the spine. If it slips too much, the bone might press on a nerve, which will cause pain. Usually, the bones of the lower back are affected. Spondylolisthesis can lead to a deformity of the spine as well as a narrowing of the spinal canal or compression of the exiting nerve roots.

Spondylolisthesis occurs most commonly in younger adults (age 30 to 50). It is often divided into 5 main types based on the cause of the vertebrate slippage, which includes: isthmic, degenerative, traumatic, dysplastic and pathologic. The prevalence of spondylolisthesis ranges from 6% to 9% of the population.

Causes

There are various causes of spondylolisthesis.

  • A family history of back problems.

A vertebra might be defective from the time a person is born. People who are born with a defect in the pars interarticularis bone in the spine are at increased risk of spondylolisthesis.

  • Abnormal wear on the cartilage and bones, such as arthritis

The condition mostly affects people over 50 years old. It is more common in women than in men.

  • A history of repetitive trauma or hyperextension of the lower back or lumbar spine

Bone disease and fractures can also lead to spondylolisthesis. Certain sports activities, such as gymnastics, weightlifting, and football, greatly stress the bones in the lower back. This can trigger a stress fracture on one or both sides of the vertebra, which may make a spinal bone become weak and shift out of place.

Symptoms

People with spondylolisthesis may have no obvious symptoms. However, symptoms may occur due to the weakness of the spine at the level of the spondylolisthesis. Low back pain is the most common symptom. The pain usually spreads across the lower back and might feel like a muscle strain.

Other possible symptoms are:

  • Pain radiating down the legs
  • Stiffness in back and legs
  • Lower back tenderness
  • Muscle spasm
  • Thigh pain
  • Tightness in hamstring and buttock muscles

Diagnosis

To diagnose spondylolisthesis, physical exams are the first step. Besides, the diagnosis of spondylolisthesis is easily made by using plain radiographs.

  • X-ray – A test that uses invisible electromagnetic energy beams to produce images of bones. A lateral X-ray will show if one of the vertebrae has slipped forward compared to the adjacent vertebrae. Spinal dislocation or slippage, kyphosis, scoliosis, as well as local and overall spine balance can be assessed with X-rays.
  • Magnetic resonance (MR) imaging – It provides detailed images of soft tissues like the spinal cord and nerve roots. MRIs are very helpful in identifying compression of the nerves associated with spondylolisthesis.
  • Computed tomography scan (CT scan) – This scan uses X-rays and a computer to provide images that are more detailed than general X-rays.

Treatment

The treatments for spondylolisthesis generally have both non-operative and operative ones, depending on the severity of pain and vertebra slippage.

Non-operative treatment can help ease pain and encourage the bone to go back into place. It’s necessary to avoid contact sports during the healing process. Common non-operative treatment methods include:

  • A back brace
  • Physical therapy exercises
  • Over-the-counter or anti-inflammatory drugs
  • Epidural steroid injections

For patients who have severe, progressive and intolerable symptoms, surgery may be considered when conservative treatments do not work.

The goal of the surgery is to alleviate the pressure on any of the nerve roots and to strengthen the attachment between the vertebrate. Adults suffering from severe cases of spondylolisthesis may need to have a surgery called spinal fusion.

The success rate of this surgery is very high. After the spinal fusion is complete, it will take four to eight months for the bones to fully fuse together. Outcomes and recovery after surgery are improved with physical therapy rehabilitation.


Keywords: spondylolisthesis.

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* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.