Degenerative Spondylolisthesis refers to a “slipped vertebral body” and is identified when one vertebra slipped forward to its adjacent or to the one below it. This is usually as a result of the normal aging process of the ligaments, joints and bones in the spine thus the spine begins to get weak and makes it unstable making the spinal column misaligned.
Degenerative Spondylolisthesis usually strikes individuals ages 50 and above. It is more common to females than males with a ratio of three females is to one male. When we speak of degenerative Spondylolisthesis, it usually happens at one or two levels in the lumbar spine like the L3 to L4 level or the most common location which is the L4 to L5 level.
This condition is seldom seen in other levels of the spine although it may appear in two or even three levels at the same time. Though it is very common to occur in the lumbar spine there are cases too that it will occur in the neck or cervical spine but if it happens, it usually is a result of arthritis in the facet joints.
Symptoms of Degenerative Spondylolisthesis
Major symptoms of degenerative Spondylolisthesis may include the following;
• Individuals suffering from degenerative Spondylolisthesis complain of sciatic pain most of the time. They often feel aching pain in one or both legs when they stand for prolonged period of time.
• Most patients do not experience any pain when sitting but with upright position you might experience pain because of the pinched nerve in the canal.
• Lower back pain or leg pain is the most common symptoms of degenerative Spondylolisthesis. But symptoms can vary from one individual to another, some may not experience back pain at all and some does but no leg pain.
• Some may experience decrease flexibility in the lower back.
• Nerve root pinching can result to weakness in the legs.
If you care to see the anatomy of the lumbar spine you will discover that there is no spinal cord in the lumbar spine. The spinal cord actually ends at L1 level so even if the patient experience severe pain, there is no danger of spinal cord damage. If the patient has disc herniation then they can develop into a condition called cauda equina syndrome where symptoms of loss of bowel or bladder control or progressive nerve root damage. This condition is seldom so that if it happens it usually needs medical emergency.
Diagnosis of Degenerative Spondylolisthesis
Diagnosis of degenerative Spondylolisthesis should be done by a spine specialist and the processes involves getting the complete medical history of the patient and review its symptoms and what makes it worse or better. Next is complete physical examination where patient is check for any physical symptoms like flexibility, range of motion, neurological symptoms or any muscle weakness. After the physical examination, x-ray may be done to confirm the diagnosis. Further test may be needed like MRI scan.
Treatment of Degenerative Spondylolisthesis
There are a lot of options when you talk about treatment for degenerative Spondylolisthesis but there are four categories that patients can choose from and they are the following;
Changes in Activity
Patients can change or modify their activities so that they spend more time sitting and lesser time walking and standing. This changes usually includes short period of rest, avoiding walking or standing for a long time, avoid active exercise and avoiding activities that need bending backwards.
If this changes in activity alleviates your symptoms especially pain then this is indeed one way to manage the condition in long term basis. Self-care at home can be done like application of heating pads or cold packs, taking of pain relievers like acetaminophen or ibuprofen after any strenuous activity.
For individuals who suffers degenerative Spondylolisthesis and wants to remain active then you can do some exercise at home like a stationary biking. This is a good option since activity in sitting position is tolerable. Aside from Stationary biking, a pool therapy is also good option. It is a physical therapy done while you are in a warm swimming pool.
Other patients also get lots of benefits from a slow and controlled exercise combined with stretching. These promote flexibility which results to decrease pain and help patients function with their everyday task.
Epidural Injections
For individual who suffers severe pain especially leg pain then epidural steroid injections may be your best option. This injection is effective in controlling pain and increases patient’s ability to accomplished task by fifty percent. This can be done up to three times in a year. The length of time of the effectivity of the epidural injection is variable. The pain relief can last for a week or as long as a year!
Chiropractic Manipulation
Chiropractic manipulation can decrease the pain by mobilizing painful joints. This is done by chiropractors and other trained health professionals.
Surgery
Surgery for degenerative Spondylolisthesis is seldom needed. Symptoms for such condition can be manage with non-invasive options although surgery may be considered if the patient’s symptom affects its day to day activities and if the pain is disabling. Surgery is also necessary if the patient is experiencing progressive neurologic deterioration.