Spondylolisthesis

Spondylolisthesis is a displacement of one vertebrae on another adjacent vertebrae. This slipped vertebra misaligns part of the spinal column and must be treated as soon as it is discovered in order to prevent serious complications from developing.

Symptoms associated with spondylolisthesis often include:

  • Lower back pain
  • Upper leg pain
  • Gluteal/buttocks pain
  • Oversensitive nerves near the slipped vertebrae
  • Stiffness and muscle tightness

If it remains untreated,spondylolisthesis can result in increased lordosis (swayback) or kyphosis (roundback), which can in turn lead to a pronounced slouching position, neurological deficits and decreased lung capacity.

Types of Spondylolisthesis

There are several different types of spondylolisthesis, ranging from fairly common divisions to rare congenital defects:

  • Isthmic Spondylolisthesis is considered the most common form of spondylolisthesis. It normally develops in children between the ages of five and 17, often causing no symptoms. The slip in the vertebra normally does not progress beyond its initial movement, and is thus is only treated if the slip is considered “high grade” (less than 10% of all slips), meaning that the vertebra is 50% or more displaced off of the inferior bone segment.
  • Degenerative Spondylolisthesis is a common form of spondylolisthesis that develops naturally as a person ages due to the prevalence of arthritis in the elderly. As the facets wear down over time, they shift their orientation slightly, allowing a mild slip to occur. These slips are asymptomatic and usually are not found until spinal stenosis has exacerbated the slip. This combination of spine ailments is the most frequent indication of spine surgery in the elderly population.
  • Dysplastic Spondylolisthesis is a very rare congenital defect concerning the malformation of the lumbosacral junction, also known as spondylolysis. Specifically, the facet joints are extremely underdeveloped and possess little surface area, which prevents treatment via posterolateral fusion.
  • Traumatic Spondylolisthesis is also a very rare subtype, characterized by a fracture of the pars interarticularis or interior facets that occurs as a result of a severe impact.
  • Pathologic Spondylolisthesis is an extremely rare type of spondylolisthesis that only occurs in the presence of equally rare metabolic bone diseases.

Diagnosis

Your doctor will take a complete medical history and perform a physical examination. Spinal X-rays may be taken to determine whether a vertebra is misaligned and if there are any existing fractures.

Treatment

Treatment for the various forms of spondylolisthesis is considerably less varied than the subtypes of the disorder itself. The two general forms of treatment are conservative pain management and rehabilitation, as well as surgical fusion of the vertebrae, usually of the posterolateral nature.

However, most patients are recommended to follow the rehabilitation and NSAID/acetaminophen treatment path for a suitable period of time (up to six months) before surgery is considered.

Surgery can consist of posterior lumbar laminectomy, discectomy, correction of spondylolisthesis and instrumented fusion. This may be able to be performed in a minimally invasive fashion if the anatomy allows.

Contact our office to learn more more about these conditions or to schedule a consultation to discuss how we may help you.