Spondylolisthesis

Spondylolisthesis

Spondylolisthesis occurs when one of the vertebra (bones) of the spine slips out of alignment with the other vertebrae in the spine.

Common symptoms of Spondylolisthesis can include:

  • Muscle Spasms in the lower back.
  • Moderate to Severe pain in the lower back, hamstrings, and buttocks.
  • Lumbar Radiculopathy or Sciatica. The symptoms from a nerve compressed because of lumbar stenosis or a pinched nerve in the back can include:
    • Pain
    • Burning sensation in the area
    • Numbness or tingling sensation from the lower back into the buttocks, thighs, legs and feet.
    • Neurogenic Claudication – cramping sensations in the buttocks or legs, particularly when walking
    • Weakness in the muscles of the legs and ankles

Isthmic Spondylolisthesis (Lytic Spondylolisthesis)
This type of spondylolisthesis is caused by a fracture of the “pars interarticularis” which is the bony bridge that connects the joints of the spine, called facet joints. It often occurs in patients that have participated in sports that involve repetitive stress to the lumbar vertebrae. The defect in the bone caused by the fracture is termed a spondylolysis. If separation or displacement of this fracture occurs, the anterior (front) portion of the vertebra will disconnect from the facet joints. The resulting slippage of the vertebrae is known as a spondylolisthesis.

Degenerative Spondylolisthesis
This type of spondylolisthesis is most often seen in older patients. Degenerative Spondylolisthesis is caused by arthritis of the facet joints in the back of the spine along with a loss of integrity of the intervertebral disc. This may lead to instability of the spine with slippage of the vertebra and further wear and tear on the intervertebral disc. 

Treatments:
The majority of individuals with a spondylolisthesis do not require surgery. Common non-surgical treatment options include:

  • Anti-inflammatory medications
  • Epidural Injections
  • When pain symptoms are severe, if there is significant muscle weakness, or if your overall condition deteriorates surgery may be necessary. The surgeons at Comprehensive Spine Care will develop a treatment plan based on your symptoms, physical exam, and MRI results.

Surgery for Lumbar Spondylolisthesis typically would consist of a Lumbar decompression (Laminectomy, Laminotomy). Stabilization of the spine may also be necessary (Anterior Lumbar Interbody Fusion, Posterior Lumbar Fusion, Lateral Lumbar Fusion.)

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