Spondylolisthesis involves a slippage of one of the vertebrae of the spine either forward or backward, making it no longer aligned with the rest of the spinal column.
Spondylolisthesis can occur as a complication of spondylolysis, a stress fracture of a portion of the vertebra. It usually causes no symptoms and occurs in about seven percent of the population. Symptomatic spondylolisthesis is most common in athletes, such as weight lifters or soccer players who engage in activities with repetitive extension.
In diagnosing spondylolisthesis, your Midwest Orthopedic Specialty Hospital physician will need to obtain a thorough medical history. This history will include duration, severity of symptoms and exacerbating activities.
It is common with patients who have degenerative spondylolisthesis to also have moderate to severe spinal stenosis. Your physician may request an X-ray to show the structure of your spine and the positions of your vertebrae relative to each other.
Treatments for Spondylolisthesis
Your physician will grade your spondylolisthesis on a scale of one to five based on the severity, assigning a number to the level of “slippage” or misalignment of the bones in your back. This can range from a 25 percent slippage at Grade 1, to a complete dislocation at Grade 5. The level of slippage will determine the course of spondylolisthesis treatment to be taken.
To manage your condition, your physician may recommend:
- Physical therapy with emphasis on core strengthening
- Interventional spine procedures such as epidural steroidal injections, facet injections or radiofrequency ablation
- Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen
- Narcotic analgesics for severe back or leg pain
These measures are only able to provide temporary relief, and in more severe cases, or those that do not respond to non-surgical treatment, spinal decompression and fusion surgery may be required.
Surgery for spondylolisthesis will most likely involve:
- Spinal Fusion — This surgical procedure involves fusing together the unstable bones in your spine to prevent rubbing or motion between the bones. When these bones are unable to rub together, the pain is eliminated. This prevents stretching and compression of the nerves and ligaments surrounding the affected bones.
- Laminectomy — Depending on the nature of your spondylolisthesis, your surgeon may also remove part of the bone that makes up your spinal segment called the “lamina” to treat the spinal stenosis.