Spondylolisthesis is a spinal condition that occurs when one of the lumbar vertebrae slips forward onto the bone directly beneath it. If the vertebra slips too far, it can press on nerves and cause severe back pain, leg pain, or numbness. In most cases, spondylolisthesis responds well to conservative treatment.
Causes of Spondylolisthesis
Spondylolisthesis is a common overuse injury seen in young people who participate in sports that require repetitive overstretching of the lower back, such as gymnastics, football, and weight lifting. Over time, this overuse can weaken the pars interarticularis (a small segment of bone that joins the facet joints in the back of the spine), which can cause vertebra to fracture or slip. Degenerative disc disease, fractures from an accident or fall, arthritis, bone spurs, and herniated discs can also result in the onset of spondylolisthesis.
Symptoms of Spondylolisthesis
Symptoms vary in their severity and usually affect the lower back.
- The most common symptom of spondylolisthesis is lower back pain that can radiate to the buttocks and back of the thighs. This pain may feel similar to a muscle strain that can worsen with activity and improve with rest.
- Muscle spasms
- Back stiffness
- Tight hamstrings
- Difficulty standing and walking
- More severe cases of vertebra slippage can result in tingling, numbness, or weakness in one or both legs. These symptoms are the result of pressure on the spinal nerve root.
Spondylolisthesis is diagnosed through a physical exam and image studies. X-rays are used to determine whether the vertebra is out of place, while CT scans give a more detailed image to determine if the misplaced bone is pressing on any nerves.
Treatment for spondylolisthesis varies depending on the severity of pain and vertebra slippage. Nonsurgical treatment options help relieve painful symptoms and encourage the vertebra to go back into place. Some common nonsurgical treatment options include:
- Wearing a back brace
- Physical therapy
- Anti-inflammatory medications
- Epidural steroid injections
Surgery for spondylolisthesis is recommended if the misplaced vertebra has slipped so far down the spine that it doesn’t respond to conservative treatment options. Spinal fusion is the most common surgical method used to correct patients suffering from spondylolisthesis.
Spinal fusion is a procedure used to permanently join two or more vertebrae into one solid bone with no space between them. Recovery time generally requires several months for the bones to heal and completely fuse together. During the first 6 weeks of recovery, patients will not be allowed to lift anything over 10 to 15 pounds, and will need to avoid bending and twisting movements. Patients will also be prescribed a back brace to help immobilize the back. Physical therapy is also an important part of recovery.