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Spondylolisthesis

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Spondylolisthesis (spon + dee + lo + lis + thee + sis) is a condition of the spine where one of the vertebrae slips forward or backward on top of another. Spondylolisthesis can lead to deformity of the spine as well as a narrowing of the spinal canal causing stenosis (compression of spinal canal or nerve roots).

There are five major types of Spondylolisthesis to be aware of :

  • Degenerative Spondylolisthesis: this is the most common cause of this condition and is basically due to the natural aging process. Over time, aging causes damage to the tissues of the body, including the bones, joints and ligaments that link the vertebrae of the spine together.
  • Dysplastic Spondylolisthesis: this is caused by a defect in the formation of part of the vertebrae called the facet that allows it to slip forward. This condition is congenital (the patient is born with it).
  • Isthmic Spondylolisthesis: this is caused due to a specific defect between adjacent vertabraes in the spine called spondylolysis. This condition is most commonly · caused due to repetitive trauma during childhood. Some sports, such as gymnastics, diving, football, and hockey are thought to make children more susceptible to developing spondylolysis as an adult.
  • Traumatic Spondylolisthesis: this is due to direct trauma or injury to the vertebrae of the spine such as a fracture.
  • Pathologic Spondylolisthesis: this is caused by a defect in the bone caused by abnormalities such as a tumor.

Symptoms of Spondylolisthesis include:

  • Lower back pain that may get worse with exercise.
  • Decreased range of motion of the lower back.
  • Tightness in the hamstrings (back of thighs).
  • Numbness or tingling in the legs.
  • Shock like feeling traveling down the leg.
  • Muscle weakness of the legs.
  • Problems with bowel or bladder function in severe cases.

Diagnosing Spondylolisthesis is usually done with the assistance of X-rays as it is not usually possible to see visible signs of the condition. A lateral X-ray view will show if one vertebrae has slipped forward compared to an adjacent vertebrae. If other conditions are suspected, the doctor may order an MRI or CT scan to determine if there are any underlying conditions.

Treatments

The treatment of Spondylolisthesis (spon + dee + lo + lis + thesis) may vary depending on the severity of the patient's condition and underlying causes, as well as patient's age, they type of Spondylolisthesis and the symptoms the patient is experiencing.

In the case of a small slip where the symptoms are manageable, then we may opt for a conservative treatment that includes modified activity, physical therapy, anti-inflammatory medications as well as pain medications or possible epidural steroid injections by one of our pain management experts.

When the slip is more significant, surgery may be recommended as there may be a risk of the problem progressing. Patient with nerve pain from compression would benefit from surgery as nerves can become permanently damaged if there is prolonged compression of the nerve. The type of surgery depends on the type cause of the Spondylolisthesis as well as whether or not there is nerve damage or pain. Our experts at SCCNS evaluate each patient on a case by case basis to determine the most beneficial path for treatment.

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