Spondylolisthesis: Symptoms, Causes and Treatment

Spondylolisthesis is a medical term used for describing vertebral slippage in the spinal column. The human spine has a perfectly aligned S shape, but spondylolisthesis distorts this alignment.

With spondylolisthesis, a vertebra slips forward or backward onto the vertebra below.

What is Spondylolisthesis

Spondylolisthesis is a condition in which one vertebra in the spine slips out of place onto the vertebra below it. This can occur due to a variety of causes, including degenerative changes in the spine, congenital defects, or injury. Depending on the cause, spondylolysis spondylolisthesis can be classified into 5 different types: degenerative, isthmic, dysplastic/congenital, pathogenic, and traumatic spondylolisthesis.

The most common type of spondylolisthesis is called isthmic spondylolisthesis, which occurs when a defect in a portion of the vertebra called the pars interarticularis allows the vertebra to slip out of place. Degenerative spondylolisthesis, which is caused by the natural wear and tear of the spine, can also occur in older adults.

Spondylolysis and spondylolisthesis can lead to a number of symptoms, including chronic back pain, nerve compression, and difficulty with physical activity. In severe cases, spondylolisthesis surgery may be necessary to correct the condition.

Diagnosis of lumbar spondylolisthesis typically involves a combination of medical history, physical examination, and imaging tests, such as X-rays, CT scans, or MRIs. Treatment may include physical therapy, pain management, bracing, activity modification, and in some cases, surgery.

If you are experiencing symptoms of spondylolisthesis, it is important to seek prompt medical attention to reduce the risk of further complications and to develop a personalized treatment plan to manage your symptoms.

5 Types of Spondylolisthesis

  • Degenerative Spondylolisthesis: Most commonly caused by degenerative diseases. It’s usually found in older people and is especially common among African-Americans.
  • Isthmic Spondylolisthesis: Affects both adults and children. It is generally caused by a small fracture(s) in the pars interarticularis, part of the facet joint.
  • Dysplastic Spondylolisthesis: Also known as congenital spondylolisthesis, is a result of a congenital birth defect.
  • Pathogenic Spondylolisthesis: This form of spondylolisthesis is caused by diseases such as tumors or infections.
  • Traumatic Spondylolisthesis: The result of a bone fracture from a traumatic event.

Spondylolisthesis Grades

The severity of spinal spondylolisthesis is measured by the degree of slippage, or the percentage of one vertebral body that has slipped forward on another. The higher the spondylolisthesis grade, the more severe the condition is. Each of the four spondylolisthesis grades represents a 25% slippage.

Although vertebral slippage from spondylolisthesis can occur anywhere on the spine, it is most common in the lower back and is a major source of lower back pain. Even though in many cases, spondylolisthesis symptoms can be improved with non-surgical treatments, although serious spondylolisthesis may need surgery.

Spondylolisthesis Symptoms

Spondylolisthesis symptoms include:

  • Back pain: The most common symptoms of spondylolisthesis are different back pain. The spondylolisthesis pain can be dull or sharp and may worsen with activity or when standing for long periods of time.
  • Muscle tightness or spasms: The muscles in the affected area may become tight or go into spasm as a result of the vertebral displacement.
  • Numbness or tingling: In some cases, spondylolisthesis can compress nerve roots and cause numbness or tingling in the legs or feet.
  • Weakness: If the nerve root is compressed, it can result in muscle weakness in the legs or feet.
  • Stiffness: The spine may become stiff, making it difficult to move or twist.

Spondylolisthesis Causes

Some people are born with a genetic predisposition to spondylolisthesis, which makes them more likely to develop the condition. Some people are born with congenital defects in the spine, such as a narrow spinal canal, that can increase the risk of spondylolisthesis.

Over time, the vertebrae in the spine can begin to degenerate, leading to instability and slippage. Injuries, such as a car accident or fall, can cause a vertebral fracture and also lead to spondylolisthesis.

Repetitive motions, such as heavy lifting or participating in certain sports, can put excessive stress on the spine and lead to spondylolisthesis.

Certain conditions, such as osteoporosis or Paget's disease, can weaken the bones in the spine and increase the risk of spondylolisthesis.

Spondylolisthesis Complications

The slippage of one vertebra onto another can lead to chronic back pain, which can be difficult to manage.

Moreover, the displacement of a vertebra can narrow the spinal canal and cause spinal stenosis, leading to pain, numbness, or weakness in the legs. The slippage of a vertebra can also lead to instability in the spine, making it more vulnerable to injury and increasing the risk of further vertebral slippage.

Spondylolisthesis can limit physical activity and make it difficult to perform everyday tasks or participate in athletic activities.

Spondylolisthesis Risks

There are several risks associated with spondylolisthesis. The slippage of a vertebra can compress nerves in the spine, leading to numbness, tingling, or weakness in the legs or feet.

In severe cases, surgery may be required to treat spondylolisthesis. This procedure can carry risks, including infection, bleeding, and complications from anesthesia.

It is important to be aware of these risks and to seek treatment for spondylolisthesis as soon as possible. A doctor can perform a physical examination, imaging tests, and possibly refer you to a specialist to develop a treatment plan and reduce the risk of further complications.

Spondylolisthesis Diagnosis

Spondylolisthesis can be diagnosed through a combination of medical history, physical examination, and imaging tests. The following steps are typically involved in diagnosing spondylolisthesis:

To collect a medical history, your doctor will ask about your symptoms, as well as any previous back injuries or conditions that could be contributing to the slippage of the vertebra.

Your doctor will perform a physical examination to assess your posture, range of motion, and any areas of tenderness or weakness.

To confirm a diagnosis of spondylolisthesis, your doctor will likely order imaging tests, such as a lower back X-ray, CT scan, or MRI. These tests can provide a detailed view of the vertebrae in the spine and determine the degree and type of slippage. Your doctor may also perform a neurological exam to check for any signs of nerve compression, such as numbness, tingling, or weakness in the legs or feet.

After a thorough evaluation, your doctor can diagnose spondylolisthesis and determine the best course of treatment for your specific needs. It is important to follow your doctor's recommendations and to stay engaged in your care to reduce the risk of further complications.

Spondylolisthesis Treatment

Treatment for spondylolisthesis will depend on the severity of the condition and the symptoms it is causing.

Physical therapy can help to strengthen the muscles in the back, improve posture, and reduce pain. Pain management techniques, such as pain medications, heat therapy, or massage, can help to reduce pain and improve quality of life.

In some cases, a brace can be used to support the spine and prevent further vertebral slippage.

Changing certain activities, such as avoiding heavy lifting or avoiding certain sports, can help to reduce the risk of further vertebral slippage.

In severe cases, surgery may be required to correct spondylolisthesis. Surgery options can include spinal fusion, laminectomy, or laminoplasty, depending on the specific needs of the patient.

It is important to work with a doctor to determine the best spondylolisthesis treatment plan for your specific needs. In some cases, a combination of treatments may be necessary to manage symptoms and prevent further vertebral slippage. Regular follow-up appointments and adherence to a recommended treatment plan can help to reduce the risk of further complications.