Description of Spondylolisthesis
Spondylolisthesis is a term used to describe vertebral slippage. It is characterized by the displacement of one vertebra over another, and slippage can occur in any direction. Spondylolisthesis is found most frequently within the lumbar (lower back) region of the spine. This is due to the fact that this area is exposed to a great deal of pressure caused by movement associated with lifting heavy objects and twisting the torso. The lumbar region also bears most of the weight of the upper body. Gymnasts, weightlifters, football players, hockey players, and other athletes are especially susceptible to spondylolisthesis because of the tremendous amount of stress they place on their lower backs. But even though the condition is seen frequently in athletes, spondylolisthesis can also be inherited or present at birth (a congenital condition), a result of an injury or trauma to the spine, or an effect of aging.
Spondylolisthesis Symptoms and Diagnosis
The symptoms of spondylolisthesis include tightness or stiffness of the back muscles, pain in the thighs and buttocks, and pain in the area of the spine where the slippage has occurred. Grades are used to classify the condition, with Grade I spondylolisthesis signifying the least amount of slippage and Grade V representing 100 percent slippage. The less slippage there is, the less likely it is that symptoms will become debilitating.
Symptoms might be experienced at the actual site of the spondylolisthesis, or they could be felt in an apparently unrelated area of the body. Pain and stiffness are most common at the site of the vertebral slippage, but if a displaced vertebra makes contact with (compresses) a nearby nerve root, a set of neurological symptoms known as radiculopathy could be produced. Radiculopathy is characterized by radiating pain, tingling, numbness, and weakness or loss of function in a group of muscles innervated by the compressed nerve root. The areas affected by nerve compression symptoms will depend on the location of the vertebral slippage. Vertebral displacement in the lower back means the legs, feet, and toes might be affected. In the cervical (neck) region, the shoulders, arms, hands, and fingers could experience symptoms. Spondylolisthesis in the neck or back also can lead to spinal cord compression, which could result in severe loss of muscular function or even paralysis in the lower body.
To reach a diagnosis of spondylolisthesis, a doctor will use an X-ray or a CT scan to confirm the presence of vertebral slippage. The slippage will then be assigned a grade of I-V, which will help determine the type of treatment necessary.
Treatment prescribed for spondylolisthesis varies. Factors taken into account include the severity of the condition, as well as the overall health of the patient. A doctor often will first recommend a regimen of exercise and stretching, along with activity modification or a back brace. Other potential treatment options include physical therapy, nerve-block injections, chiropractic adjustments, and in rare cases, spine surgery.
If a diagnosis of spondylolisthesis has been accompanied by a recommendation of open back surgery as a treatment option for nerve compression, patients may want to consider a minimally invasive, outpatient procedure, like those offered at Laser Spine Institute. Our endoscopic procedures require no overnight hospitalization, and greatly reduce the risks and recovery time inherent to open back surgery. For more information, visit our FAQ page or contact us to ask questions. We also offer potential candidates for our endoscopic procedures a complimentary review of their MRI or CT scan.