Spondylolisthesis is a condition that affects the spine and causes a vertebra (a bone in the spine) to slip out of place. This can put pressure on the nerves, tissues, and other bones in the spine, which can cause pain and make it hard to move. Some common causes of spondylolisthesis include:
- Stress fractures
- Deterioration due to age or overuse
- Injuries and accidents
- Congenital birth defects
Depending on the location of the displaced vertebra, patients typically experience symptoms that may include:
- Severe back or neck pain
- Stiffness or immobility
- Pain in the extremities, hips, buttocks, or legs
- Difficulty in standing, sitting, or walking normally
- Numbness or weakness in the extremities
- Increased pain when turning, bending, or moving
- Possible bowel and bladder control issues
It is not uncommon for patients to experience one or more of these symptoms. In some cases, spondylolisthesis may not produce any noticeable symptoms at all.
When you have back pain, your doctor may use X-rays to figure out what’s causing the pain. X-rays can show if one of the bones in your spine (vertebra) has slipped out of place. This is called spondylolisthesis. If the X-ray shows that you have spondylolisthesis, your doctor may want to order additional tests. They may order specialized X-rays with you standing and bending in different directions. They may also use CT scans and/or MRIs to get a better look at your spine. These more detailed studies can help your doctor understand the severity or degree of misalignment and also determine if it is unstable.
In addition, your doctor may be looking for another complicating condition that can be seen with spondylolisthesis. This is where a single vertebra may have separated into two pieces. This different but similar-sounding condition describes a break in a specific area of the vertebra and is called spondylolysis. This type of stress fracture (spondylolysis AKA “Pars defect”) can be found in conjunction with the vertebrae slipping out of place (spondylolisthesis). To sum that up, a break in the vertebra that slips out of place would then be called a spondylolisthesis with a pars defect (or spondylolisthesis with spondylolysis). That last part can be a real tongue-twister for some people.
Ultimately it is important to gather more information to help your doctor decide on the best way to treat your spondylolisthesis in an attempt to reduce your back pain.
Non-surgical Treatments for Spondylolisthesis
If you have been diagnosed with spondylolisthesis, your doctor may tell you to avoid activities that put a lot of stress on your back. This means avoiding heavy lifting, running, or other intense exercises that also includes excessive bending and twisting.
Depending on how severe the degree of your spondylolisthesis is, your doctor may initially recommend a more conservative approach. Over-the-counter pain medicine, like ibuprofen or acetaminophen, can temporarily help with pain and swelling. If your pain is more severe, your doctor may give you a prescription medicine to help control it. This might also include a combination of pain management and reducing your activity level to allow your spine time to heal. In some cases, your doctor may suggest injections as well to help control your pain. Physical therapy should be used to both relax and strengthen your core-stabilizing muscles. Your doctor may also recommend a back brace to provide extra support during certain activities. If these conservative approaches fail to provide sustained relief, corrective or stabilization surgery may be your best option.
If non-surgical methods fail to provide relief for pain and dysfunction caused by spondylolisthesis, surgery may be the last resort to fix the displacement of the vertebrae and ease the pressure on the bones, nerves, and tissue in and around the spinal column. Two of the most common surgical procedures used to treat this condition are spinal fusion and a decompressive laminectomy (AKA Spinal decompression surgery).
- Spinal fusion, although it may sound scary, can be a lifesaver as it uses advanced bone graft and other hardware technology combined with advanced surgical techniques to fuse two vertebrae together, creating a new stable bone structure that prevents the displaced vertebra from returning to its misaligned state. Depending on how many levels are stabilized, patients may note some mild loss of mobility and flexibility in the affected area.
- Decompressive laminectomy, on the other hand, can be a true game-changer. In spondylolisthesis that is determined to be stable, a surgeon removes a small portion of the bone (lamina) of the displaced vertebra and any additional excessive tissue that may be causing pressure and pain at the site. This procedure can often provide significant pain relief for patients suffering from spondylolisthesis.
These modern surgical techniques can now be performed as minimally invasive surgical procedures that often can be performed in outpatient surgery centers. This means possibly no trip to a hospital for surgery, reducing your risk of catching an infection from simply being in a hospital. With more advanced surgical instrumentation and imaging tools, modern surgeons can now get the job done through smaller incisions. Minimally invasive surgery commonly lends to shorter surgery time that requires less anesthesia medication, less blood loss, less scar tissue, and ultimately faster recovery times in comparison to traditional open-back procedures. The goal is a quicker return to normal activities.
In all cases of chronic or severe back pain, it is essential to seek the advice of a qualified medical professional. Early detection is often the key to full recovery, so individuals who suspect they may suffer from spondylolisthesis or any other spinal disorder should consult a physician for diagnosis and treatment, to minimize unnecessary suffering.