Spondylolisthesis

Some patients develop a slippage of one vertebra on the next one below. The slip is a gradual process. It can lead to back pain and nerve related problems. It does not always require surgery.

Sometimes we fix the slip in the position and at times we reduce it and fuse it in the corrected position.
Based on the extent of the slip we call it either High grade or Low grade.

Causes, Symptoms and Treatment Options

What is Spondylolisthesis?

Spondylolisthesis is a common type of spinal deformity where one vertebra of the spine slips forward or backward relative to other vertebrae causing back pain. This slippage further can squish the nerves that run from the spine to other parts of the body, causing excruciating pain in body parts those squished nerves happen to go. For example, if the slippage of the vertebrae occurs in the lower back, the spondylolisthesis, in this case, may cause pain, numbness, tingling in the legs.

What Causes Spondylolisthesis?

There is no single cause of spondylolisthesis. Some of the individuals are born with a spinal defect that may result in spondylolisthesis later in their life. Vertebrae slippage in some individuals may be caused by injury, disease or normal wear and tear due to aging. Some of the typical causes of spondylolisthesis are birth defects, degeneration due to aging, bone abnormalities, repeated trauma to the spine, and conditions like Osteoporosis, fractures or joint injuries.

Types of Spondylolisthesis:

While spondylolisthesis in children is normally is caused by birth defects, in adults, it is caused by the wear and tear of the spine due to aging. However, the slippage can occur in many ways, in varying degrees and hence the condition of Spondylolisthesis has been classified into the following categories to treat the condition effectively.

Congenital Spondylolisthesis:

Congenital spondylolisthesis is the condition where the vertebrae slippage is a result of birth defects in the spinal bone formation. When the bones are misaligned in the spine, they cause an additional pressure on the disc inducing a slippage. This type of spondylolisthesis mostly occurs in children and teens in their growth spurt.

Isthmic Spondylolisthesis:

Isthmic spondylolisthesis is another type of adult spinal deformity which also is a common type of spondylolisthesis among adults and adolescents. The slippage of the vertebrae here is caused stress fracture (breaks) mostly in the lower spine area. These fractures usually occur in the adolescent years but the symptoms may present themselves in later years in most cases.

Degenerative spondylolisthesis:

As we age, the general wear and tear weakens the bones, ligaments, and discs increasing the probability of vertebrae slippage in the lower spine resulting in Degenerative Spondylolisthesis. It commonly occurs in adults over 50, even more among people older than 65.

Apart from the above, there are other types of Spondylolisthesis that are less common: Traumatic Spondylolisthesis, caused by spinal fracture or slippage; Pathological Spondylolisthesis, caused by diseases, and Post-surgical Spondylolisthesis caused after spinal surgery.

Symptoms of Spondylolisthesis:

Spondylolisthesis does not always cause the symptoms. A person who has had Spondylolisthesis may not even know it until the symptoms gradually present themselves as they age. Lower back pain is the most common symptoms of Spondylolisthesis and other typical symptoms include Pain in legs, thighs, and buttocks, tight leg muscles and hamstrings, change in shape of the back, weakness in legs, difficulty in walking, running or bending over. If you experience any of the above symptoms you are requested to consult the doctor for Spondylolisthesis i.e. a Spinal Surgeon.

Diagnosis and Spondylolisthesis Treatment options:

Diagnosis of Spondylolisthesis is simple and straight forward. It starts with the questionnaire about the symptoms, and physical exam, and a back X-ray. The imaging studies help in identifying, grading the severity and finding the exact location of slippage. The severity is graded in four levels as follows:

Normally Grade 1 & II are treated using non-surgical options like medications, physiotherapy, bracing but Grade III and Grade IV slippages may require surgical options to treat the condition in case the pain is severe and persistent. Pars repair, Spinal Decompression, Spinal fusion are some of the spondylolisthesis treatment procedures.

As said before some people with spondylolisthesis may not experience any symptoms. But for the people who do, the pain which starts offs as a mild pain can further intensify as the slippage progresses significantly impacting their day to day life. But the good news is only rare and extreme cases need surgery to get rid of this problem. All the pain, numbness, and difficulties caused by the spondylolisthesis can be treated using medication and therapy in the majority of cases.