Spondylolisthesis

Spondylolisthesis occurs when one vertebra slips forward in relation to adjacent vertebrae. The condition can be a source of back pain, leg pain and other symptoms.

What Is Spondylolisthesis?

This condition takes place when the vertebra slides forward on the adjoining vertebrae. Spondylolisthesis may be inborn or the result of physical stress on the spine or spinal disintegration. It leads to gradual abnormality of the lower spine and narrowing of the vertebral canal. Immediate effects include back and leg pains.

Types of Spondylolisthesis

There are five kinds of this disorder, namely Types I to V.

Spondylolisthesis
Type I

is described as dysplastic spondylolisthesis and is caused by hereditary defects of superior sacral or lower L5 facets or both with steady falling of the L5 vertebra.

Type II, there is a deficiency in the pars interarticularis but no slipping takes place. This is normally known as spondylolysis. This variety can be classified into Types II A, B and C.

Spondylolisthesis
Type II A
Spondylolisthesis
Type II B
Spondylolisthesis
Type II C
Spondylolisthesis
Type III

Type III is known as degenerative spondylolisthesis which is the gradual worsening of lumbar facet joints. Adjustment in these joints can bring about forward or backward vertebral dislocation. It is frequently diagnosed among grown-up patients.

Type IV or traumatic spondylolisthesis is related to severe fracture of a posterior part such as pedicle, lamina or facets but not pars interarticularis.

Type V is pathologic spondylolisthesis which happens due to structural weakness of the secondary bone like a tumor or serious bone disorder.

Spondylolisthesis
Type IV
Spondylolisthesis
Type V

Common Indications

The most widespread symptom is pain in the lower back. Patients can develop the laceration between five and seven years of age, but symptoms will not emerge until they reach 35 years. Any abrupt twisting or lifting movement will lead to a severe occurrence of back and leg pains. Aside from back pains, patients may also feel leg soreness. A lot of patients with spondylolisthesis will have unclear symptoms and almost no evident deformity. The initial physical sign is usually stiffness of hamstring muscles. Abnormality in the spine transpires only when the slip reaches beyond 50 percent of the vertebral body’s thickness. At times there can be mild muscle contraction and tenderness may be felt in said area. The range of motion is not affected but some pain is felt in the hyperextension.

Diagnosis

Doctors may perform a physical test and diagnostic screening like x-ray, computed tomography scan or magnetic resonance imaging. The diagnosis is confirmed by observing the forward position of one vertebral body in relation to another body. For those without any indications of nerve constriction or neurologic injury, initial treatment is made up of non-surgical braces and anesthetic spinal injections also may be prescribed.

Spine surgery is the last option only after all other moderate therapies fail to alleviate symptoms within a certain period of time or if signs of nerve involvement including lack of feeling, muscle infirmity, bowel or bladder injuries occur.

Surgical procedures can consist of spinal decompression, which involves removing the bone(s) causing the pressure. Another alternative is spinal fusion where bone graft material is placed between the vertebrae to restore stability of the spine. Nonetheless, you have to consider the advantages as well as the disadvantages of surgery before choosing this procedure.

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