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Spondylolisthesis

    At a Glance

    • Spondylolisthesis is a common condition in which one vertebra shifts out of position relative to other vertebrae; this is also called a slipped vertebrae.
    • The two most common types are spondylolytic spondylolisthesis, which affects young teenagers, and degenerative spondylolisthesis, which affects people over age 60 and is more common in women.
    • Treatment varies from medications to complex surgery. There is some controversy whether to correct the deformity or leave it.

     

    Symptoms of Spondylolisthesis

    The type of back pain associated with spondylolisthesis tends to be a burning pain where the affected areas feel hot as though on fire. Patients may also experience Sciatica.

    In most back conditions there will be pain either in the back or in one or more of the limbs. With spondylolisthesis, patients typically feel severe pain in both the back or neck AND the extremities.

    Scoliosis or Curvature of the Spine, in which the spine resembles a “C” or “S,” may be present in spondylolisthesis.

     

    Anatomy & Causes

    Sometimes one vertebra shifts out of position relative to other vertebrae. The abnormal shift can occur at any location in the spine. The shift can move forward (anterolisthesis), backward (retrolisthesis), or sideway (laterallisthesis). Spondylolisthesis is sometimes referred to as shifted spine or Slipped Vertebrae.

    Flat back is a posture change associated with a spondylolisthesis that has shifted backward. This causes the entire lower spine to completely straighten or flatten. Flat back deformity, sometimes called kyphotic spine or kyphosis, also affects the thoracic and cervical spine.

    There are five different types of spondylolisthesis named for the underlying reason that causes the condition to occur. The two most common types are spondylolytic spondylolisthesis and degenerative spondylolisthesis.

    Spondylolytic spondylolisthesis is an acquired condition that occurs primarily in young teenagers and is carried throughout life. It is believed to be a stress fracture involving a small part of the posterior vertebrae called the pars interarticularis that never heals properly.

    • About seven out of every 100 people in western culture have this type of spondylolisthesis, though 90 percent are unaware of the condition throughout life. It is very common in young and professional athletes.
    • Symptoms may include back pain, sciatica, numbness, and in severe cases weakness of the lower extremities, including a condition known as “foot drop.”

     

    In contrast, degenerative spondylolisthesis occurs mostly in people over age 60.

    • The condition occurs as part of the instability and stabilization phases of the Spinal Degeneration Process.
    • Symptomatic degenerative spondylolisthesis is often associated with severe central canal spinal stenosis and pinched nerve(s) symptoms. Many patients cannot walk due to significant pain, numbness, and weakness. This problem is called Neurogenic Claudication. The condition does not go away and can be crippling.
    • The specialists at Biscup Spine have identified three types of degenerative spondylolisthesis: 85 percent of cases are Type III, or stable degenerative spondylolisthesis.
    • Special diagnostic testing is required to determine which type of degenerative spondylolisthesis a person has.

     

    Spinal instability refers to a vertebra and spinal-motion segment that is moving too much: either front to back, side to side, or up and down. It can occur with a spondylolisthesis, and the terms are often used interchangeably. However, spinal instability may occur without a spondylolisthesis, and may be a separate problem.

    Frequently Asked Questions

    Is minimally invasive surgery available?
    Is spinal instability the same as spondylolisthesis?
    more faqs »

     

    Learn about Spondylolisthesis treatment options.

    Treatment for spondylolisthesis

    Early detection and a correct diagnosis can ensure that there are no other underlying problems that will cause more serious symptoms in the future. A skilled specialist carefully reviews the anatomy and clinical symptoms to determine the most appropriate, and least invasive, procedure to perform.

    Non-surgical Treatments

    These of are usually effective in treating spondylolisthesis, and include:

     

    Pain Management

    • Epdiural
    • Transforaminal Epidural.

     

    Surgical Treatments

    Surgery may occasionally be required if care and the above treatments fail.

    • If the patient is young and/or has a healthy intervertebral disc and facet joints, the surgeon may perform a minimally invasive surgery involving primary repair of the bone defect.
    • If advanced degeneration AND spinal instability are present along with central and/or foraminal spinal stenosis, the surgeon may recommend performing a decompression Laminectomy AND spinal fusion.
    • If fusion surgery is deemed necessary, an experienced surgeon should determine appropriate variations in approach and technique that will produce the best results. There are many available.

     

    However, if the condition is STABLE, one option is the minimally invasive Micro Decompression Laminaplasty surgery for Type III degenerative spondylolisthesis where a fusion surgery is not necessary. This avoids the need for more aggressive decompression and fusion procedures. It is an operation that can “give you your life back.”

    Types of spinal fusion surgery:

    • Percutaneous Spinal Fusion (Minimally Invasive Spinal Fusion)
    • Spinal Fusion Without Instrumentaions and Implants (Simple Spinal Fusion)
    • Spinal Fusion With Instrumentations and Implants. (Complex Spinal Fusion)

     

    Always ask a spine doctor if there is an alternative to spinal fusion surgery. If he or she says no, get another opinion.

    Non-Surgical Treatments

    Pain Management

    Surgical Treatments

    OTC Medicine
    Ice
    Heat
    Massage and Massotherapy
    Traction
    Water Exercises
    “Core” Exercise Program Including Pilates and Yoga
    Physical Therapy
    Bracing
    Selective Nerve Block
    Epidural
    Transforaminal Epidural
    Percutaneous Spinal Fusion Sextant
    Spinal Fusion Without Instrumentations and Implants
    Spinal Fusion With Instrumentation and Implants
    Major Spine Reconstruction

     

    Frequently Asked Quesions

    Do I need surgery for spondylolisthesis?
    more faqs »