It occurs when a weakened part of a vertebra called pars interarticularis separates, which makes the vertebra move out of position. The
result is pinched nerves, which causes pain, Spondylolisthesis generally occurs between the fourth and fifth lumbar vertebrae or the last lumbar
vertebra and the sacrum. This location is where the spine curves into its ‘S’ shape, where the stress is most pronounced.
Symptoms:
Mild cases of spondylolisthesis usually cause little pain and the person concerned is not even aware of it. The condition is often
discovered when a person has an X-ray of the back taken for another reason.
However, in other cases the patient may experience low back pain, muscle spasms and stiffness. He or she may also have sciatica,
pain which radiates down one or both legs. The pain may worsen as the person stands or walks. There may also be numbness, though it is uncommon.
The faster the vertebra slips the more pain it generates. Less painful symptoms can be tightness in the hamstrings. The patient may not
be able to touch his or her toes, but there may be no nerve pain.
Diagnosis:
When pain persists, a doctor should be immediately consulted. The physician checks the patient’s complete medical history, including
prior injuries. Your lifestyle habits will also be discussed to determine where it is causing the pain. A physical examination follows, which
includes tests for numbness or muscle weakness. Imaging tests like the following allow the doctor to locate the precise source of pain:
- X-Rays
- Magnetic resonance imaging (MRI)
- Computed Tomography (CT)
- Single Photon Emission Computed Tomography (SPECT)
Treatments:
Non-surgical treatments include self-care, braces, physical therapy, medications, steroid injections and holistic therapy.
Surgery:
If the slippage continues, it may not respond to conservative treatments and surgery may be required to realign the vertebrae. The spinal
surgeon will first decompress the nerves in a procedure called laminectomy. A bone graft is then inserted within the disc space, at the angle of the
slipped vertebra. This is followed by inserting pedicle screws into the bones below and above the slip. The surgeon leverages the screw to pull the
vertebra back into alignment and secures it in its proper place with a rod.
New bone will grow across the graft within 3 to 6 months, permanently fusing the two pieces of bone. Spinal fusion can correct both the
compression of the nerve roots and the stability of the spine. The operation is successful in 90 out of 100 cases because it stops the slippage and
keeps the spinal canal from further narrowing.
