Jason E. Smith MD
Spine Surgeon with Baton Rouge Orthopaedic Clinic
Call Us: 225-924-2424
What Is Spondylolisthesis?
Spondylolisthesis occurs when one vertebra slips forward on the adjacent vertebrae. The condition may be congenital (hereditary), or the result of physical stresses on the spine or spinal degeneration. It may produce both a gradual deformity of the lower spine and also a narrowing of the vertebral canal, and can cause back pain, leg pain and other symptoms.
There are different types of Sponylolysthesis and depending on the grade/degree of forward shift of the vertebral body will determine which type you have.
What Are The Symptoms Of Spondylolysthesis?
The most common symptom of spondylolisthesis is low back pain. Many times a patient can develop the lesion (spondylolysis) between the ages of five and seven and not present symptoms until they are 35-years-old, when a sudden twisting or lifting motion will cause an acute episode of back and leg pain.
Usually the pain is relieved by extension of the spine and made worse when flexed. The degree of vertebral shift does not directly correlate with the amount of pain a patient will experience. Fifty percent of patients with spondylolisthesis associate an injury with the initial onset of their symptoms.
In addition to back pain, patients may complain of leg pain. In this instance, there can be associated narrowing of the area where the nerves leave the spinal canal that produces irritation of a nerve root.
Many patients with spondylolisthesis will have vague symptoms and very little visible deformity. Often, one of the first physical signs of spondylolisthesis is tightness of the hamstring muscles in the legs.
How Is Spondylolisthesis Diagnosed?
To determine if spondylolisthesis is the cause of your symptoms, your doctor may, in addition performing a physical exam, recommend a diagnostic test such as an x-ray, computed tomography (CT) scan or magnetic resonance imaging (MRI). The diagnosis of spondylolisthesis is confirmed by noting the forward position of one vertebral body on another.
How Is Spondylolysthesis Treated?
Your doctor will be able to discuss with you what your diagnosis means in terms of treatment options. For most people without any signs of nerve compression or other neurologic impairment, the first line of treatment consists of non-surgical therapies such as medication, rest and physical therapy. Epidural spinal injections also may be recommended.
Spine surgery is typically considered only after conservative therapies fail to adequately relieve symptoms over a significant period of time, or if evidence of nerve involvement, such as numbness or tingling, muscle weakness or bowel or bladder impairment, develops.
Surgical procedures that may be recommended for the treatment of spondylolisthesis include:
The benefits of spine surgery, however, must be weighed against the risks. Discuss with your surgeon the risks and benefits of surgery, and the potential results of operative versus non-operative treatment. Every patient is different and must have a customized approach.
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