Let’s start by analyzing the word spondylolisthesis. Spondylo refers to the spine. Listhesis means slipping. Put them together and the word refers to a slip in the spine.
Before going further, here’s a quick review of the spine’s anatomy. The bones in the spine are called vertebrae. They comprise the spine’s building blocks. Discs sit between the vertebrae. Each disc contains an inner layer of soft cartilage known as the nucleus pulposus. Surrounding this is a layer of tough cartilage called the disc annulus.
Thus, spondylolisthesis is when one of the vertebrae slips out of place. This often occurs at the base of the spine in the lumbar region that most refer to as the lower back. When a vertebra slips forward on top of the one below, it could potentially put pressure on the nerve. This causes pain in the lower back or leg.
What Are the Causes and Symptoms of Spondylolisthesis?
Sometimes spondylolisthesis with spondylolysis can be mixed up. The latter is a crack or stress fracture in the bones of the spine. It’s possible for spondylolysis to cause spondylolisthesis. A stress fracture can be the root cause of the vertebra slipping.
A degenerative disc condition can lead to a slipped vertebra. Discs experience wear and tear from aging and heavy physical activity. They wear down and weaken the connection between the vertebrae, which leads to spondylolisthesis. A traumatic injury can also force the slip. Some examples of these types of injuries include car accidents, falling off a ladder, or a football player defensively pushing and tackling other players.
The most common symptom of spondylolisthesis is lower back pain. The pain can be more noticeable after exercising. Other possible symptoms:
- Hamstring muscle spasms or tightness
- Pain from bending over
- Change in walking to waddling
- Back stiffness
- Trouble standing or walking
How Spondylolisthesis Is Diagnosed and Treated?
To diagnose spondylolisthesis, a healthcare provider will review the patient’s medical history and ask questions. The physician conducts a physical exam and ask about symptoms. Most likely, it will require an imaging scan like an X-ray, CT, or MRI to confirm the diagnosis.
A diagnosis of spondylolisthesis includes the grade of the slippage. This indicates the severity of the spondylolisthesis. Grades 1 and 2 mean the vertebra has slipped forward by 25 to 50 percent. Grades 3 and 4 denote a slippage of 75 percent or more. Grade 5 indicates the vertebra has fallen off completely.
Treatment depends on the grade. Noninvasive treatment options include rest, anti-inflammatory medicine, steroid shot, bracing, physical therapy, or a combination. While they won’t fix the slippage, they can provide pain relief.
If the patient does respond to noninvasive treatments, it may require spinal decompression. The surgeon removes the bone and disc, then fuses the vertebrae. The good news is that spondylolisthesis is not dangerous and won’t affect a person’s lifestyle for the long-term.
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