Spondylolisthesis symptoms can vary from patient to patient, especially in terms of severity. Just as the condition’s symptoms can fluctuate, so too can the treatment plans recommended by physicians. Learning about the condition can enable patients to have informed discussions with their doctors, which can potentially lead to the development of a more comprehensive treatment regimen.

Anatomy of the Spine

While “spondylolisthesis” may be difficult to spell and pronounce, most individuals are able to understand what the condition is once they become familiar with the spine’s various anatomical components. Simply put, the spine is made up of a large bundle of nerves (the spinal cord) and an intricate shield of bone, known as the spinal column, that not only serves to protect the spinal cord, but also enables us to freely move our necks and backs.

The spinal cord runs from the base of the skull to the upper portion of the lower back. This “information superhighway,” as it is often called, transmits motor and sensory information from the brain to the rest of the body by way of tiny nerves that branch from the spinal cord and travel throughout the body. The spinal cord is encased by a series of bone structures called vertebrae. Most individuals have 33 vertebrae, including nine that are fused together to form the coccyx and sacrum, and 24 that are articulated and connected with one another in the neck and the back. Articulating vertebrae are attached to each other with facet joints, which enable the neck and back to bend, twist, and perform all other movements. Intervertebral discs are located between each pair of vertebrae and act as shock absorbers to ease the strain and pressure that is placed on vertebrae when the spine facilitates movement or bears weight.

Spondylolisthesis Explained

Spondylolisthesis occurs when one vertebra slips forward and over the vertebra located directly beneath it. This typically occurs when the slipped vertebra isn’t receiving ample support from the spine’s other anatomical components. More often than not, an individual develops spondylolisthesis as a result of the natural aging process, which has caused the intervertebral discs and the facet joints to slowly deteriorate. These degenerative changes can cause certain spinal conditions that may contribute to the development of spondylolisthesis, including:

– Facet disease – Also called facet syndrome and spinal arthritis, facet disease occurs when the cartilaginous lining of the facet joints wears away. This can lead to pain and inflammation, and sometimes results in the development of bone spurs (osteophytes).

– Herniated discs – Over time, the outer shell of an intervertebral disc (the annulus fibrosus) can become brittle and lose some of its elasticity. A weakened disc wall can sometimes rupture, allowing the disc’s inner contents (nucleus pulposus) to seep into the spinal canal.

– Bulging discs – In the case of a bulging disc, the annulus fibrosus weakens to the point that it is no longer able to contain the nucleus pulposus within its normal boundaries. Unlike a herniated disc, the annulus fibrosus remains intact and the nucleus pulposus remains fully contained. However, the disc’s contents can shift, causing the disc to balloon or bulge to one side.

Because the anatomical components of the spine work harmoniously to protect the spinal cord, damage to one mechanism can have a drastic effect on the others. In the case of spondylolisthesis, weakened facet joints can enable one vertebra to shift over another. Likewise, vertebral slippage can be caused by a damaged intervertebral disc that cannot properly reduce the impact that is placed on its surrounding vertebrae.

Spondylolisthesis Symptoms

Interestingly, a slipped vertebra doesn’t typically cause any pain and discomfort on its own. Rather, it is the contact a slipped vertebra makes with a spinal nerve or the spinal cord that causes spondylolisthesis symptoms. As a result, the extent and severity of a patient’s symptoms will largely depend on the degree to which the vertebra has slipped out of place. The degree of a patient’s spondylolisthesis is measured in terms of grades:

– Grade 1: Up to 25 percent slippage

o Many patients with Grade 1 spondylolisthesis remain completely asymptomatic and may not even realize they are afflicted with a spinal condition.

– Grade 2: Between 25 and 50 percent slippage

o Grade 2 spondylolisthesis symptoms can include pain, numbness, tingling, and muscle weakness. The intensity of these symptoms is typically mild to moderate and may radiate into the hips, buttocks, legs, and/or feet.

– Grade 3: Between 50 and 75 percent slippage

o In addition to the radiating symptoms associated with Grade 2 spondylolisthesis, Grade 3 can lead to tightened hamstrings and a stiffened back.

– Grade 4: Between 75 and 100 percent slippage

o Grade 4 is typically classified as “severe” spondylolisthesis, and most patients suffer from significant pain and discomfort. These patients may also develop an altered gait that may resemble a “waddle” and their posture may significantly change.

– Grade 5: 100 percent slippage

o Grade 5 spondylolisthesis symptoms can include severe pain and discomfort that may interfere with the patient’s quality of life. These patients may also have visible deformities and may be experiencing neurologic abnormalities.

Relieving Low-Grade Spondylolisthesis Symptoms

The symptoms of low-grade spondylolisthesis, which includes grades 1 through 3, can typically be managed with the use of conservative, nonsurgical treatments. Many physicians advise their patients to take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen. Other medications, such as analgesics, prescription muscle relaxants, and narcotic pain relievers may also be recommended or prescribed, depending on the patient, the severity of his or her symptoms, and his or her overall level of health.

Low-grade spondylolisthesis symptoms can also sometimes be managed by working with a physical therapist. Exercises that target the core muscles can improve strength and flexibility, helping to relieve neural compression and provide added support to the spine. In addition to strength training, physical therapists may use other treatment methods, such as transcutaneous electrical nerve stimulation (TENS), cryotherapy, thermotherapy, and therapeutic ultrasound, among others.

Spondylolisthesis symptoms can also oftentimes be relieved when certain lifestyle changes are made. Obese patients, for instance, can greatly benefit from shedding excess pounds that are placing an increased burden on the spine. Other lifestyle changes can include:

– Quitting smoking

– Reducing alcohol consumption

– Becoming more active

– Eating more nutrient-rich foods

Occasionally, conservative treatments may provide patients with little to no relief from their low-grade spondylolisthesis symptoms. These patients may want to consider undergoing a minimally invasive procedure that endoscopically relieves neural compression. An orthopedist, neurologist, or other type of physician can evaluate whether a patient is a candidate for a minimally invasive spine procedure for treating low-grade spondylolisthesis.

Treating High-Grade Spondylolisthesis

Unlike low-grade spondylolisthesis symptoms, those that accompany Grades 4 and 5 oftentimes require more invasive surgical treatment. These operations typically entail fusing the affected vertebra with the one positioned directly above or below it. Bone grafts, vertebral cages, and a variety of supporting hardware are often installed during spinal fusion surgeries. Patients with high-grade spondylolisthesis should consult their physicians about the treatment options that are available to them.

Patrick Foote is the Director of eBusiness at Laser Spine Institute, the leader in endoscopic spine surgery. Laser Spine Institute specializes in safe and effective outpatient procedures for the treatment of spondylolisthesis and several other spinal conditions.

Patrick Foote is the Director of eBusiness at Laser Spine Institute, the leader in endoscopic spine surgery. Laser Spine Institute specializes in safe and effective outpatient procedures for several spinal conditions. http://www.laserspineinstitute.com/back_problems/spondylolisthesis/

Author Bio: Patrick Foote is the Director of eBusiness at Laser Spine Institute, the leader in endoscopic spine surgery. Laser Spine Institute specializes in safe and effective outpatient procedures for the treatment of spondylolisthesis and several other spinal conditions.

Category: Medicines and Remedies
Keywords: Spondylolisthesis