Spondylolisthesis – Symptoms, Types, Diagnosis, Treatment

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What is Spondylolisthesis?

The word Spondylolisthesis comes from the Greek words ‘spondylos’, which means ‘vertebra’ or ‘spine’ and ‘listhesis’ which means’ sliding, slipping or movement’. Spondylolisthesis is a spinal condition affecting the lower vertebrae of the spine, causing lower back pain. It occurs when one of the vertebrae moves more than it should and falls out of alignment onto the vertebra below it.

The most common location where spondylolisthesis takes place is at the base of the spine. A slipped vertebra can cause pain in your lower back or legs by putting pressure on a nerve. This condition is painful, but it’s usually treatable. It is possible to use both medicinal and surgical approaches to treat this condition. Proper workout techniques can help you avoid spondylolisthesis.

Note: Spondylolisthesis can be confused with Retrolisthesis. Retrolisthesis is a backward or rearward slippage whereas spondylolisthesis or anterolisthesis is a forward or frontward slippage. Another word for retrolisthesis and spondylolisthesis is vertebral displacement.

Types of Spondylolisthesis

Some common types of spondylolisthesis include:

Degenerative Spondylolisthesis:

It is the most common type of spondylolisthesis and occurs as a result of aging. The discs that cushion the vertebrae lose water over time. They are more likely to fall out of place as they become thin.

  • Congenital Spondylolisthesis:

It occurs when a baby’s spine does not develop properly before birth. The person’s vertebrae are misaligned, putting them at risk for slippage later in life.

  • Isthmic spondylolisthesis:

This occurs as a result of spondylosis. The bone is weakened by the crack or fracture.

Some less common types of spondylolisthesis include:

Pathological spondylolisthesis:

This occurs as a result of some tumor or disease such as osteoporosis.

  • Traumatic spondylolisthesis:

This condition occurs when the vertebra slips due to an injury.

  • Post-surgical spondylolisthesis:

This happens when there is a slippage as a result of spinal surgery.

Signs and Symptoms of Spondylolisthesis

The signs and symptoms of spondylolisthesis vary from person to person. In severe cases, you may be unable to perform your daily activities. However, in mild cases, you may not feel any symptoms at all. Most of the people have this condition, but they don’t know it. Some of the common symptoms of spondylolisthesis include:

  • Persistent pain in the lower back
  • Muscular spasms in the hamstring
  • Tenderness in the lower back
  • Tightness and stiffness in the your back and legs
  • Difficulty in standing or walking for a longer period
  • Weakness, tingling and numbness in the foot
  • Pain when bending over
  • Pain that gets worse with activity
  • Pain spreading down your legs

Causes of Spondylolisthesis

Based on age, hereditary and lifestyle, the causes of spondylolisthesis vary. Some of the common causes of spondylolisthesis are as follows:

  • This disorder may affect children as a result of a birth defect or an injury.
  • If the disorder runs in the family, people of all ages are at risk.
  •  Some people have thinner vertebral bones that are prone to slipping and cracking.
  • Rapid growth during adolescence may also play a role in the onset of this condition.
  • Wear and tear on the spine and discs (the cushions between the vertebrae) may cause this condition in older adults.

One of the most common causes of spondylolisthesis in young athletes is overextending the spine. Sporting activities will cause your strain to overstretch, putting stress on your lower back. This disorder is more likely to occur in people playing the following sports:

  • Track and field
  • Gymnastics
  • Football
  • Weightlifting

Diagnosis of Spondylolisthesis

The first step to diagnose this condition is to carry out a physical exam. You will find it difficult to raise your leg straight outward during simple exercises if you have spondylolisthesis. If your doctor suspects you have spondylolisthesis, they’ll ask you about your symptoms and perform imaging tests to see if a vertebra is misaligned. These imaging tests may include:

  • X-ray
  • MRI scan
  • CT scan

X-rays of the lower spine are important for deciding if a vertebra is misaligned. On your x-ray images, your doctor may look for any possible fractures in the bone. If the misplaced bone is pressing on your nerves, your doctor may order a more thorough and detailed CT scan or MRI scan.

Your doctor may assign a grade to you based on the severity of your spondylolisthesis. Low-grade (I or II) is less severe and does not normally require surgery. High-grade (III and IV) is more severe. If you’re in a lot of pain, surgery might be appropriate.

Treatment for Spondylolisthesis

The treatment for spondylolisthesis depends on your symptoms, the grade of the slippage, age, and your overall health. You doctor will tell you about the various treatment options. Medication, physical therapy, or surgery may be needed by you.

Non-Surgical Treatment Options

Non-surgical treatments can help relieve pain and allow the bone to return to its original position. During the healing process, it’s crucial to stay away from contact sports. Some of the common non-surgical treatments include:

  • Medication: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAID), such as naproxen (Aleve®) or ibuprofen (Motrin®) can help relieve the pain associated with spondylolisthesis. If those don’t work, your doctor may prescribe you some other medications.
  • Rest: Take a break from your daily activities and sports.
  • Bracing: A brace will aid in the stabilization of your spine. The brace restricts movement in order to allow fractures to heal. Adults should not wear braces.
  • Injections: You receive an injection of steroid medications directly into the affected region.
  • Physical Therapy: A physical therapist will give you specific abdominal (belly) and back strengthening exercises. Pain is usually relieved after a few weeks of daily workouts.

Surgery As a treatment for Spondylolisthesis

If you have a high-grade spondylolisthesis, the pain is extreme, or nonsurgical treatments have failed, you will need a surgery called a spinal fusion. When the bone has slipped so far down that nonsurgical treatments are ineffective, surgical correction of the misplaced vertebra is needed. Surgery may also be needed if the bones of the spine are pressing on the nerves.

Your doctor will use a bone graft and metal rods to help support your spine. An internal brace can be used to support the vertebra as it heals. The main goals of a spondylolisthesis surgery are:

  • Reduce pain from the irritated nerve
  • Stabilizing the spine at the site of the vertebral slippage
  • Restore your function

The bones will take four to eight months to fully fuse together after the spinal fusion is done. The success rate of the surgery is very high. You can gradually resume your normal activities until you are able to function and move properly.

Bottom Line

If you think you may be suffering from spondylolisthesis, you should see your doctor right away. The majority of symptoms of this disorder can be alleviated with early care and treatment options. Sometimes, spondylolisthesis may come back again for a second time. This is more likely to happen if the spondylolisthesis is of a higher grade. If you’ve had spondylolisthesis surgery, you’ll most likely be fine. Within a few months of surgery, most people are able to resume their daily activities. However, the spine will no longer be as flexible as it once was.