Spondylolisthesis

Here's a breakdown of its description, symptoms, causes, treatment options, common warning signs, and some case examples:

Spondylolisthesis

Spondylolisthesis is a spinal condition where one of the bones in your spine (called a vertebra) slips out of place, moving forward over the bone directly below it. This shift can put pressure on the nerves in the spine and lead to pain, discomfort, or difficulty with movement.

Types of Spondylolisthesis

Different types of spondylolisthesis exist, each with unique causes and characteristics.

Congenital Spondylolisthesis

  • This type is present at birth due to a developmental issue in the spine. Some people may not have symptoms until later in life, when the condition causes the vertebra to slip forward.
  • Symptoms, if they appear, often include back pain, difficulty with movement, and sometimes numbness or tingling.

Isthmic Spondylolisthesis

  • Caused by a small fracture or defect in a part of the vertebra called the “pars interarticularis,” this type usually results from overuse or repetitive stress (often in sports like gymnastics or weightlifting).
  • This type is more common in younger individuals who are active. Symptoms may include lower back pain, stiffness, or leg discomfort.

Degenerative Spondylolisthesis

  • Commonly seen in older adults, this type occurs due to the natural aging process, where discs and joints in the spine wear out over time.
  • Symptoms include lower back pain, leg pain, or numbness that may worsen with activity and improve with rest.

Traumatic Spondylolisthesis

  • Resulting from a sudden injury, such as a car accident or a fall, this type occurs when a vertebra is pushed out of place due to trauma.
  • Symptoms can vary depending on the severity of the injury but may include pain, weakness, or difficulty moving.

Pathologic Spondylolisthesis

  • Caused by diseases that weaken the bones, such as tumors or infections, this type is less common but requires prompt treatment.
  • Symptoms include severe back pain, instability, or nerve issues, and it often needs medical evaluation for an underlying condition.

Post-Surgical Spondylolisthesis

  • This rare type can develop after spinal surgery if the spine becomes destabilized.
  • Symptoms may include back or leg pain and often require further medical intervention to correct.

Common Symptoms 

Spondylolisthesis can vary in severity, so symptoms may differ from person to person. Some people may not notice symptoms, while others may experience:
  • Lower back pain that worsens with activity
  • Stiffness in the back or legs
  • Tingling or numbness in the legs, if nerves are affected
  • Muscle tightness or weakness, especially in the hamstrings
  • Difficulty walking or standing for long periods

How Spondylolisthesis is Diagnosed

To confirm a diagnosis, Dr. Shankar Acharya may use imaging tests like X-rays, MRIs, or CT scans to see if a vertebra has slipped out of place and assess the degree of slippage. He will also examine any nerve compression caused by this shift.

Treatments offered for Spondylolisthesis

Surgery may be recommended if symptoms are severe or if there is significant nerve compression.
Non-surgical Treatments:  For most types of spondylolisthesis, treatment starts with non-surgical options.
    • Physical therapy to strengthen muscles around the spine and improve flexibility
    • Pain-relieving medications or anti-inflammatory drugs
    • Bracing to stabilize the spine in younger patients
    • Activity modification, including avoiding activities that strain the lower back

Surgical Treatments:

In cases where non-surgical treatments don’t relieve symptoms or if there is severe nerve compression, Dr. Acharya may recommend surgery to realign the vertebrae and stabilize the spine. Surgical options can involve:
  • Spinal fusion to fuse the affected vertebrae together, which can prevent further slipping
  • Decompression surgery to relieve pressure on the nerves

Living with Spondylolisthesis

With the right treatment and lifestyle adjustments, many people with spondylolisthesis continue to lead active, fulfilling lives. Dr. Shankar Acharya and his team are here to guide you through each step of managing and treating spondylolisthesis, helping you achieve the best possible quality of life.