When a vertebra slips forward or backward when compared to the one next to it, it’s known as spondylolisthesis. This can lead to a deformity in the spine and cause the spinal canal to become narrowed or compress the nerve roots.
Five Types of Spondylolisthesis
There are five types of Spondylolisthesis including:
- Dysplastic spondylolisthesis is caused when the facet part of the vertebra slips forward. Most likely, you were born with this condition if you have it.
- With isthmic spondylolisthesis, the pars interarticularis portion of the vertebra is defective. It can be caused by sports where there is a lot of motion that hyperextends the body, such as gymnastics or football.
- Traumatic spondylolisthesis is caused by an injury. This can include fractures in the pedicle, lamina or facet joints, allowing the vertebra to slip forward.
- Degenerative spondylolisthesis is due to cartilage degeneration in the joints caused by arthritis. It occurs in older patients.
- Finally, there’s pathologic spondylolisthesis, which is caused by an abnormality in the bone, such as a tumor.
Lower back pain is the primary indicator of the possible presence of spondylolisthesis. It can become worse after exercise or motion that stretches the lumbar part of the spine. Other symptoms can include pain, numbness or a tingling sensation or weakness in the legs.
In most cases, an x-ray can detect the slippage and confirm that there is spondylolisthesis. The disease is graded according to the amount of slippage relevant to the neighboring vertebra.
- Grade I is a slip of up to 25%
- Grade II is between 26%-50%
- Grade III is between 51%-75%
- Grade IV is between 76% and 100%
- Grade V, also known as spondyloptosis, occurs when the vertebra has completely fallen off the next vertebra.
Additional tests such as a CT scan or MRI can identify compression due to spondylolisthesis.
The course of treatment depends on the symptoms and severity. Initially, your doctor will recommend short periods of rest and avoiding lifting, bending and athletics. Physical therapy may help improve your range of motion as well as overall muscles strength.
For pain, anti-inflammatory medications can help. If there is pain, numbness or tingling, your doctor may give you an epidural injection of cortisone. In other cases, such as those involving isthmic spondylolisthesis, a brace may help the body heal properly.
If surgery is required, your doctor will discuss the available procedures as well as their benefits and risks. Surgical approaches depend on many factors, including the type of spondylolisthesis you have and your overall health.