Spondylolisthesis is a slippage of one vertebral body in relationship to its neighboring vertebrae.
Based on the cause of displacement, six subtypes of spondylolisthesis are identified, they are
- Dysplastic spondylolisthesis
- Isthmic spondylolisthesis
- Degenerative spondylolisthesis
- Traumatic spondylolisthesis
- Pathologic spondylolisthesis
- Iatrogenic spondylolisthesis
Among the various subtypes of spondylolisthesis, the two most common forms commonly observed are degenerative spondylolisthesis and isthmic spondylolisthesis.
Degenerative spondylolisthesis – This subtype is caused by degeneration of the discs and facet joints due to aging, which causes one vertebrae to slip forward on the one below it which can be associated with spinal stenosis, or pressure on the nerves.
Isthmic spondylolisthesis – This type of spondylolisthesis occurs because of a defect in the pars interarticularis part of the vertebra. This is more common in young athletes and gymnasts as they often suffer from overuse injuries.
Signs and symptoms that suggest the spondylolisthesis in patients include:
- Lower back pain
- Stiffness in the back and tightening of the hamstring muscles from spasms
- Pain in the thighs and buttocks
- Decreased range of motion of the lower back
- Pain and weakness of the legs or numbness because of nerve compression
- Loss of control on bowel or bladder function by severe nerve compression
- Increase in lordosis curve, also called swayback
Treatment for spondylolisthesis is based on the particular diagnosis made by taking a detailed medical history, physical examination, and radiographic scans. During the diagnosis, also the severity of displacement is assessed which is expressed as grade I to IV. In mild conditions and for symptomatic relief, conservative treatments including medications, bracing and physical therapy are recommended. In severe cases, surgical correction with decompression of the nerves and spinal fusion is recommended. The procedure involves removal of a portion of vertebra compressing the nerves and other vertebra followed by removal of disc between the vertebrae and fusion of adjacent vertebrae. Fusion surgery is performed to confer stability to the spine. Following the surgery, your surgeon will recommend a rehabilitation program to regain strength to the surrounding bones & muscles as well as to make you active soon.