You could ask 100 people what spondylolisthesis is, and you’d get nothing but blank looks. It’s actually difficult to understand how spondylolisthesis can even happen.
This long word is the term for a condition where one of your vertebrae slides forward over the bone below it. It is most common in the lumbar spine, the bottom five vertebrae of your spinal column. When spondylolisthesis happens, the spinal column becomes misaligned and the condition should be treated as soon as it is discovered to prevent further complications.
The problem is that when this slippage occurs sometimes the person will not have any symptoms or will have symptoms that develop in later years. Otherwise the sufferer may have pain in the lower back or buttocks and other symptoms.
At Texas Neurosurgery, there are various non-surgical treatments for spondylolisthesis, but if these are not working and the patient still has pain after at least six months, we may perform lumbar spinal decompression and fusion to correct the displacement.
What causes spondylolisthesis?
The bones in your spine are aligned by several small joints that keep the bones lined up while still allowing them to move. Spondylolisthesis occurs when a problem with one of these small joints allows one of the vertebrae to move out of line.
These are some of the joint problems that can result in spondylolisthesis:
- A joint damaged by trauma
- A congenitally defective joint
- A vertebra with a stress fracture from overuse of the joint
- A joint damaged by arthritis or infection
In children and teens, participation in certain sports is often the cause of spondylolisthesis. Some sports such as gymnastics or weightlifting can overuse the back bones to a degree that a stress fracture occurs in the vertebrae, resulting in spondylolisthesis.
In older adults, spondylolisthesis can develop when wear and tear on the back leads to stress fractures. It can occur without stress fractures when the disc and joints are worn down and slip out of place.
What are the symptoms?
Although sometimes there are no immediate symptoms with spondylolisthesis, there are symptoms that often accompany the condition:
- Numbness or weakness in one of both legs
- Back or buttock pain
- Pain that runs from the lower back down one or both legs
- Pain when walking
- Leg, back, or buttock pain that gets worse when you bend over or twist.
If left untreated, spondylolisthesis can result in increased lordosis (swayback) or kyphosis (roundback). This can lead to pronounced slouching, neurological deficits, and decreased lung capacity.
Muscle strength in the lower back can be the cause of many cases of spondylolisthesis. The first treatment option is usually physical therapy to build strength and to focus on stretching. If a sport is the cause, obviously, that activity needs to stop.
Sometimes there can be nerve or spinal cord damage due to spondylolisthesis. If the pain is extreme or the bones continue to move, surgery may be necessary. The goal of surgery would be to remove any bone or other tissue that is pressing on the spinal cord or nerves. This surgery is called decompression. Usually, as mentioned above, we will also fuse the two vertebrae in question.