Spondylolisthesis

Written by Kristeen Moore | Published on August 7, 2012
Medically Reviewed by George Krucik, MD

What Is Spondylolisthesis?

Spondylolisthesis is a spinal condition that affects the lower vertebrae (spinal bones). This disease causes one of the lower vertebra to slip forward onto the bone directly beneath it. This is a painful condition, but it is treatable in most cases. Both therapeutic and surgical methods may be used. Proper exercise techniques can help keep this condition from developing.

Symptoms of Spondylolisthesis

The symptoms of spondylolisthesis vary. Patients with mild cases may not have any symptoms. However, people with severe cases may be unable to perform daily activities. Some of the most common symptoms are:

  • persistent lower back pain
  • stiffness in the back and legs
  • lower back tenderness
  • thigh pain
  • tight hamstring and buttock muscles

Causes of Spondylolisthesis

Causes of spondylolisthesis vary based on age, heredity, and lifestyle. Children may suffer from this condition as the result of a birth defect or injury. However, patients of all ages are susceptible if the condition runs in their families. Rapid growth during adolescence may also be a contributing factor.

Playing sports may also cause overstretching of the spine and stress on the lower back. The following sports are especially likely to cause this condition:

  • football
  • gymnastics
  • track and field
  • weightlifting

Spondylolysis is often a precursor to spondylolisthesis. Spondylolysis occurs when there is a fracture in a vertebra, but it has not yet fallen onto a lower bone in the spine.

Diagnosing Spondylolisthesis

Physical exams are the first step in diagnosing this condition. Patients with spondylolisthesis may have difficulty raising a leg straight outward during simple exercises. X-rays of the lower spine are crucial for determining whether a vertebra is out of place. Your doctor may also look for any possible bone fractures on the X-ray images.

Your doctor may order a more detailed computerized tomography (CT) scan if the misplaced bone is pressing on your nerves.

Treating Spondylolisthesis

The treatment for spondylolisthesis depends on the severity of pain and vertebra slippage. Nonsurgical treatments can help ease pain and encourage the bone to go back into place. It’s important to avoid contact sports during the healing process.

Common nonsurgical treatment methods include:

  • wearing a back brace
  • physical therapy exercises
  • taking over-the-counter or prescription anti-inflammatory drugs (such as ibuprofen) to reduce pain
  • epidural steroid injections

The American Academy of Orthopaedic Surgeons recommends trying nonsurgical treatments first. However, adults suffering from severe cases of spondylolisthesis may need to have a spinal fusion. Surgical correction of the misplaced vertebra is required when the bone has slipped so far down that the spine doesn’t respond to nonsurgical therapies. Surgery is also required if the bones of the spine are pressing on your nerves.

Your doctor will work to stabilize the spine by using a bone graft and metal rods. He or she may insert an internal brace to help support the vertebra while it heals. After the spinal fusion is complete, it takes four to eight months for the bones to fully fuse together. The success rate of the surgery is very high.

Potential Complications

Medical intervention is crucial for relieving symptoms of spondylolisthesis. This condition can cause chronic pain and permanent damage if left untreated. Patients may eventually experience joint weakness and leg paralysis if nerve damage is present. Infection of the spine may also occur in rare cases.

Kyphosis, also called roundback, is a complication in which the upper portion of the spine falls off of the lower half, causing increased forward spinal angulation.

Long-Term Outlook

Early treatment measures can cure most cases of spondylolisthesis. According to the National Institutes of Health, 80 percent of patients respond to conservative therapy measures. Up to 90 percent of patients respond well to surgery. (MedlinePlus)

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