Spondylolisthesis

What is spondylolisthesis?

The abnormal slipping or dislocation between two vertebrates is known as spondylolisthesis. It comes from the Greek word spondylos and oliothesis meaning vertebrate and slipping respectively. In this condition, a link in the central pillar is unstable and is a pure mechanical failure. Some people experience chronic low back pain, leg pain, or neurogenic claudication from spinal stenosis and some people experience no symptoms at all.

Types of spondylolisthesis

Type 1 – Congenital Spondylolisthesis

Congenital spondylolisthesis is a condition where a person is born with an abnormality of the posterior bony arch of the spine, which causes slippage. It happens at the L5-S1 level commonly and is associated with abnormality of the facet joints. Symptoms include back pain during the adolescent growth spurt. CT and MRI scans are required to diagnose dysplasia (abnormal bone formation).

Type 2 – Isthmic Spondylolisthesis

Isthmic spondylolisthesis is a defect in a part of the bone called the pars interarticularis. This bone connects the upper joint of one vertebra to the lower joint. A stress fracture in individuals with a hereditary predisposition (some minor abnormality or weakness of the pars at birth) usually causes this. Sometimes a defect may exist without any forward slip, and this is called spondylolisthesis. This can also be painful.

Type 3 – Degenerative Spondylolisthesis

Forward slippage secondary to arthritis of the spine is known as Degenerative spondylolisthesis. This process is usually also associated with Spinal stenosis. Long standing degenerative disc disease, leading to weak facet joints in the back of the spine is the reason. This is usually seen at the L4-L5 level. This is also called Lumbar Spondylolisthesis.

Causes of spondylolisthesis

Spondylolisthesis has many causes, some of them are:

• Above 50 years of age,
• Heredity.
• Birth defect
• Sudden injury or trauma to the spine.
• Repetitive trauma to the spine.

Symptoms of spondylolisthesis

The symptoms of spondylolisthesis vary. People suffering from mild symptoms may not have any symptoms, but those with severe cases may be unable to perform daily activities. The few most common symptoms are:

• Persistent pain in the lower back.
• Stiffness in the back and legs.
• Tenderness in the lower back.
• Pain in the thigh.
• Tightness in the hamstring and buttock muscles
• Difficulty walking.

Tests and Diagnosis of Spondylolisthesis:

• You can get an assessment of the bone anatomy with X-Rays and also the curvature and alignment of the vertebral column.
• In order to see any abnormal or excessive movement or instability in the spine at the affected levels, Dynamic or flexion/extension X-rays are done.
• To get detailed images of soft tissues like the spinal cord and nerve roots, Magnetic Resonance Imaging is conducted.
• CT-Scan provides images more detailed than X-Rays.

Treatment for Spondylolisthesis

Treatment options for spondylolisthesis include the following:

• Rest: Take rest and avoid strenuous activities or sports until the pain has subsided.
• Medications include painkillers such as non-steroidal anti-inflammatory drugs (NSAIDs), calcium supplements, and steroidal injections in non-responding cases.
• Physical Therapy: Physical therapy helps to strengthen the muscles and increase flexibility and movement. Regular physiotherapy helps alleviate the pain and inflammation.
• Bracing: Braces can be used in children to support the spine and limit movement for a quick recovery.
• Surgery: Surgery is preferred in severe cases and could involve decompression and/or fusion of the vertebras depending upon the affected area.