All about spondylolisthesis
Many patients that are diagnosed with spondylolisthesis but have absolutely no idea what it is. Mr David Bell, complex spine surgeon, will explain what it is, the symptoms it causes and how it is treated.
Spondylolisthesis is when a vertebra (bone in the spine) slips out of place, usually forward relative to another vertebra. There is a big misconception that spondylolisthesis is related to a slipped disc, however this is not the cases. A slipped is when spinal disc between the vertebrae ruptures.
Five major types of spondylolisthesis
1. Dysplastic spondylolisthesis – a congenital defect where part of the vertebra called the facet causes it to slip forward.
2. Isthmic spondylolisthesis – a defect in the vertebra which can cause it to slip
3. Degenerative spondylolisthesis – due to ageing and arthritic changes in the joints
4. Traumatic spondylolisthesis – a sudden injury or trauma such as fracture to the spine
5. Pathologic spondylolisthesis – a weakness in the spine, possibly caused by a tumour or disease
What typically causes spondylolisthesis?
The cause of spondylolisthesis varies, some people have the defect from birth, and if they have no symptoms it may not be diagnosed until later in life. Other causes of spondylolisthesis are:
· Sports injury such as gymnastics
· Degeneration (ageing or overuse)
· Tumour or illness
· Sudden injury or trauma
· Birth defect
Symptoms of spondylolisthesis can be associated with other conditions, which is why many people do not realise that they have this condition.
Most common symptoms of spondylolisthesis
· Lower back pain
· Pain and/or weakness in one or both legs or thighs
· A tingling sensation that radiates from lower back down to the legs.
· Tenderness or stiffness in the back
· Tight hamstring and buttock muscles
· Excessive curving of the spine known as lordosis
· Difficulty walking or running
Treatments for spondylolisthesis
There are many different methods that can be used to treat spondylolisthesis. The best place to start would be to simply avoid straining your back, this means not lifting, bending or doing sports, this may give your back a chance to get back to normal. If this is not successful, then your next step would be to anti-inflammatory painkillers like ibuprofen, to help reduce the pain that you are experiencing and bring down the swelling.
Other none surgical method that can be used are to have physiotherapy, stretching the lower back and hamstrings, this will help strengthen the muscles in your back and increase the motion. Corticosteroid injection can also help patients that are experiencing symptoms such as numbness, tingling and pain.
Surgery is always the last resort. Your doctor will only take you down this route if none of the conservative methods of treatments have been successful and the patient is still experiencing symptoms from spondylolisthesis. Another reason that surgery may be suggested is because it is causing trauma to the spine that will be permanent if not treated.
Depending on the type of spondylolisthesis that the patient has will decipher the surgical procedure that is necessary for their specific case. Often a laminectomy (decompression) and spinal fusion with pedicle screw instrumentation will be needed, however precise detail will be discussed with your doctor closer to the time of the surgery.
This article is intended to inform and give insight but not treat, diagnose or replace the advice of a doctor. Always seek medical advice with any questions regarding a medical condition.