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CONDITIONS

Spondylolisthesis

Spondylolisthesis refers to the instability and misalignment between two vertebral bodies and the disc separating them, typically in the lumbar or lower back region. Due to this instability and misalignment, a vertebrae may slip out of place onto the vertebrae below it. The slippage can put pressure on a nerve, leading to symptoms like back pain, leg pain, or numbness.

There are three types of spondylosis: congenital, isthmic, and degenerative. Congenital spondylolisthesis occurs from birth when the spine doesn’t form the way it should. Isthmic spondylolisthesis happens as a result of spondylolysis, where there is a stress fracture, thus weakening the bony constraints. This type of spondylolisthesis is most common in children and adolescents. The most common type, degenerative spondylolisthesis, occurs with age; Over time, discs lose their water content, and facets become degenerated making the bones more likely to slip out of alignment.

Symptoms & Diagnosis

Symptoms of spondylolisthesis can vary depending on the location of the slippage and its cause. Some may not experience any symptoms. For those who do, back pain is the most common, as well as:

  • Leg pain
  • Muscle tightness
  • Weakness in the legs, leading to difficulty walking or standing
  • Tingling or numbness in the affected area

Diagnosing spondylolisthesis typically involves a combination of medical history review, physical examination, and imaging studies, like an x-ray, MRI, or CT scan to see if a vertebra is out of place. If spondylolisthesis is confirmed, a classification system (such as the Meyerding classification) may be used to grade the severity of the slippage. In some cases, nerve studies like electromyography (EMG) may be conducted to assess nerve function and identify any nerve damage.

Treatment

Treatment of spondylolisthesis will depend on the grade of slippage, symptoms, age, and overall health. Before reaching a point where surgery is necessary, medication, physical therapy, and other non-surgical treatments can be beneficial in alleviating symptoms. Dr. Avramis will discuss all available treatment options.

Conservative treatment
  • Medication Over-the-counter pain relievers such as acetaminophen or NSAIDs can provide relief.
  • Bracing A brace can stabilize the spine, limiting movement so that fractures can heal. Bracing is typically recommended for children and adolescents with spondylolysis, not for adults.
  • Physical therapy Targeted exercises can strengthen the core and back, which can help relieve pain.
  • Injections An injection of steroid medication directly into the affected area can provide pain relief.
Surgical intervention
  • The goal of surgery for spondylolisthesis is to stabilize the bones to prevent further slippage and to relieve any associated nerve compression.
  • Decompression & fusion surgery Decompression & spinal fusion surgery are often done together for better outcomes. This may involve a laminectomy or foraminotomy and the use of implants to promote fusion between the affected bones.
While spondylolisthesis is a common cause of back pain and other symptoms, it doesn’t need to affect daily life. Many treatments are available, from medication and physical therapy to spine surgery. For patients suffering from lower back pain or who are finding it difficult to walk, schedule an appointment with Avramis Spine & Scoliosis to learn about options for treatment.
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Our team at Avramis Spine & Scoliosis is here to help. To request an appointment or for any other inquiries, please fill out the form.

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Contact

Our team at Avramis Spine & Scoliosis is here to help. To request an appointment or for any other inquiries, please fill out the form.