Spondylolisthesis is a condition where one of the vertebrae of the spine slips out of place and into the vertebra just below it. When it slips too much then it might press on a nerve which will result to severe pain. The most common area affected is the lower back.
Spondylolisthesis is the most common cause of back pain among teenagers. Symptoms of such conditions often start during adolescent stage. Degenerative Spondylolisthesis usually starts after age 40.
Some people affected with Spondylolisthesis do not experience any symptoms but for those who experience symptoms, low back pain is the most common one. This pain generally spreads to the lower back and it feels the same as muscle strain.
This condition can also cause muscle spasm in hamstring muscles in the back of the thighs thus giving one a hard time to walk. If the slipped bone is pressing on a nerve then pain might radiate down to the leg and foot. Foot might also feel numb or tingled.
There are different types of Spondylolisthesis but the most common one are Congenital Spondylolisthesis which is a result of abnormal formation of bone at birth; Isthmic Spondylolisthesis is one condition which often leads to small breaks in the vertebrae; and Degenerative Spondylolisthesis is a result of the natural process of aging were the disc lose its water making it prone to injury with every bone movement.
Less common type of Spondylolisthesis includes the following – Traumatic Spondylolisthesis where slipped bone is cause by injury; Pathological Spondylolisthesis is when spine is weakened by certain diseases like infection, osteoporosis or tumor; Post-surgical Spondylolisthesis which often happens after back surgery.
Spondylolisthesis Treatment
Treatment for this condition really depends of several factors which is the overall health of the person, age, how severe the symptoms are and of course the extent of the slippage. Treatment for this condition often involves conservative treatment like medication, exercise and rest. For more severe cases, surgery might be required.
Mostly Spondylolisthesis is graded according to the degree of slippage. Slippage is usually grade from I through IV. Grade I means 1% to 25% slip, Grade II means 26% to 50% slip, Grade III means 51% to 75% slip and Grade IV means 76% to 100% slip. Mostly Grade I and Grade II often responds to conservative treatment while Grade III and Grade IV might need surgery pain is persistent.
Conservative treatment often includes medication like anti-inflammatory to help in lessening the pain and inflammation. If this does not work then stronger medication might be prescribed like Epidural steroid injections. A back support or brace might be use to reduce pain by stabilizing your lower back. A specific exercise that is designed for you can help you move without pain, improving your flexibility as well as muscle strength.
As mentioned above, surgery may be required if pain is not relieve with conservative treatment. Its main purpose is to relieve you from pain that is linked to the irritated nerve, to steady the spine that gas slipped out and of course to improve the person’s physical function. Generally there are two surgical procedures involved to treat Spondylolisthesis and that is laminectomy and spinal fusion. Trials have been evaluated the use of bone morphogenetic protein as a replacement for autogenous bone graft. This new technologies are use with caution till long trials of such are completed ( J Am Acad Orthop Surg 2008)
Prognosis of Spondylolisthesis
Chances of recurrences of pain usually depend on the severity of the condition. For minor slip where the bone is not pressing in any nerves then the patient may not have any recurrence of pain that is associated to Spondylolisthesis. Generally eighty percent of mild cases of Spondylolisthesis are successfully treated with conservative treatment while eighty-five to ninety percent of cases with severe Spondylolisthesis are successfully treated with surgery.