SPONDYLOLISTHESIS: WHAT IT IS AND HOW IT'S TREATED

What Is Spondylolisthesis?
In basic terms, spondylolisthesis is a condition in which the vertebrae slips out of its proper position and winds up on top of the vertebrae located below it. This can lead to pinched nerves, which can be very painful. Spondylolisthesis is most common in the lumbar region of the spine, which makes sense given how the lower back bears so much of the body's weight.

What Causes Spondylolisthesis?
Spondylolisthesis is caused by problems with the joints between the vertebrae. The slippage of the vertebrae may be caused by physical injury or trauma to the back, infections of the vertebrae, arthritis, or congenital disorders.

Types of Spondylolisthesis
There are different types of spondylolisthesis to consider, each defined by its cause or causes. They include:
 

• Congenital Spondylolisthesis – This type of spondylolisthesis is present at birth and the result of abnormal bone formation.
   
• Isthmic Spondylolisthesis – This kind of spondylolisthesis is related to the condition spondylolysis, which causes stress fractures that weaken the spine.
   
• Degenerative Spondylolisthesis – This kind of spondylolysis is the result of the natural aging process affecting the health of the spinal discs. It's the most common form of spondylolysis.
   
• Traumatic Spondylolisthesis – This kind of spondylolysis is the result of physical trauma.
   
• Pathological Spondylolisthesis – This kind of spondylolysis is related to infection or a disease of the spine.
   
• Post-Surgical Spondylolisthesis – This kind of spondylolysis is the result of weakening to the spinal cord following surgery.
   

Signs and Symptoms of Spondylolisthesis


The most common signs of spondylolisthesis include:
 

• Pain the back or buttocks
• Pain radiating from the lower back to the legs
   
• Numbness or weakness of the legs
   
• Problems walking
   

In rare cases, spondylolisthesis can also lead to the loss of bowel and bladder control.


Grades of Spondylolisthesis


To determine the ideal treatment option for spondylolisthesis, the grade of the condition must be assessed through spinal x-rays. There are four grades of spondylolisthesis:
 

• Grade I Spondylolisthesis – 1 percent to 25 percent slippage
• Grade II Spondylolisthesis – 26 percent to 50 percent slippage
• Grade III Spondylolisthesis – 51 percent to 75 percent slippage
• Grade IV Spondylolisthesis – 76 percent to 100 percent slippage

In most cases, Grade I and Grade II spondylolisthesis will not require surgical treatment, while Grade III and Grade IV spondylolisthesis often require surgical treatment.


Treatment Options for Spondylolisthesis


For the most part, spondylolisthesis is first treated through a combination non-steroidal anti-inflammatory drugs (NSAID) to alleviate pain and braces to stabilize the back. Steroid injections may be used in certain cases to help reduce inflammation in the back. In addition to drugs and braces, exercise and physical therapy are a common early part of treatment. This helps strengthen the back muscles and the spine.


When surgery is required for treating spondylolisthesis, this typically means performing a laminectomy (removing part of the bone structure to alleviate compression on the nerves) and/or spinal fusion (joining two or more vertebrae together for stability). The risks and benefits of these procedures can be discussed in more detail during your consultation


Speak with Dr. Luis M. Tumialán


To learn more about treating serious back problems and restoring your flexibility and mobility, be sure to contact a skilled spinal surgeon today. Dr. Tumialán and his entire team will help you achieve wellness again.