Spondylolisthesis occurs when one of the vertebrae slips out of place onto the vertebra beneath it. Many people experience no symptoms at all from this condition, and never know they have it. However, if the vertebra that’s become misaligned slides too far, it may result in nerve compression and pain. Spondylolisthesis most commonly affects vertebrae in the lumbar spine.
Though there are several other conditions with similar names, spondylolisthesis shouldn’t be confused with spondylosis, spondylitis, or spondylolysis. Why all the nearly identical names? All of these share a common etymology, coming from spondylos, the Greek word for spine. In the case of spondylolisthesis, it’s a combination of spondylos and the word listhesis, meaning “to slide.”
What are the Symptoms of Spondylolisthesis?
Again, it’s possible to have spondylolisthesis and not know it, because no symptoms are manifested. Sometimes it never progresses to the point that symptoms develop, but in other cases, symptoms may crop up after months or years. People begin to experience symptoms of spondylolisthesis when the slipped vertebra is squeezing the spinal cord or nerve roots.
The most common symptom of spondylolisthesis is pain in the lower back, which can sometimes be mistaken for a muscle strain as it is often intensified by movement. Pain can also occur in the buttocks or legs. If the vertebra is pressing on a nerve, it can result in pain that spreads down the legs and causes feelings of weakness, tingling, or numbness that can extend to the feet. Some people experience difficulty walking as a result. In rare cases, spondylolisthesis can cause loss of bladder or bowel control. Should that occur, it’s important to see a doctor right away.
What Causes Spondylolisthesis?
Normally, your vertebrae are kept in place by several tiny joints that hold the bones in line while still allowing the spine to move. If something causes damage to one of these joints, it can result in spondylolisthesis. It is also possible to simply be born with a defective joint, in which case the spondylolisthesis is congenital.
More commonly, spondylolisthesis is the result of wear and tear on the spine. If discs are worn, it can lead to joints becoming worn down and vertebrae slipping out of place. Stress fractures caused by osteoarthritis can also damage the joints, as can infection. These causes all tend to lead to spondylolisthesis in older people.
Spondylolisthesis is not exclusively a condition for the old, however. People of any age can develop spondylolisthesis from an acute injury or trauma. Overuse injuries can occur even in children and teens who actively participate in sports that can lead to stress fractures in vertebrae.
What Treatments Are Available for Spondylolisthesis?
Spondylolisthesis is diagnosed via imaging. An x-ray, CT scan, or MRI can be used to identify whether you have a fracture or crack in a vertebra, or if one has slipped out of place. Once spondylolisthesis has been diagnosed, treatment depends on the cause and the severity of the condition.
If pain from spondylolisthesis is relatively minor, it can be managed with non-steroidal anti-inflammatory drugs. It is also important to stop any physical activity that may have led to the damage, whether that is a sport or a certain work function. However, while resting the back may be tempting, it’s critical to keep moving. Core strengthening builds up the stomach and back muscles, helping to support the spine. To ensure that you are properly performing exercises and not exacerbating injury, it’s important to consult a physician and/or work with a physical therapist.
In other cases, surgery can help to alleviate pain from spondylolisthesis. Surgery may be indicated when more conservative treatments have not reduced pain, when pain is extreme, when the vertebrae continue to slip, and/or if there is nerve damage brought on by the spondylolisthesis. Minimally invasive surgical procedures, like decompression and laminectomy, may help by removing pieces of bone that are pressing on the nerve. If a fracture is present, minimally invasive procedures like vertebroplasty or kyphoplasty may be used to strengthen and rebuild the cracked vertebra.
If you think that spondylolisthesis might be the cause of your back pain, before any treatment can proceed, it’s important to get an accurate diagnosis. The specialists at the Spine Institute Northwest can provide you with a thorough examination of your individual case. Get started today by uploading your MRI or CT scan for a free evaluation, or calling the Spine Institute Northwest at 206-496-0630.