Spondylolisthesis is not only difficult to pronounce and spell, but it can also be difficult to fully explain to others, as you’ve likely encountered yourself if you’re suffering from the condition. After complaining to friends and loved ones for weeks or months about your chronic back pain, they probably encouraged you to visit your physician. Following your appointment, your loved ones were also probably anxious to find out what the doctor had to say. Informing these individuals that you’ve been diagnosed with spondylolisthesis was almost certainly met with perplexed looks and a slew of questions: What is that? How did you get it? Is there a cure? Learning about spondylolisthesis can not only enable you to answer these and other questions, but it can also help you better understand what you can do to alleviate your symptoms.

What is Spondylolisthesis?

The majority of the population has never heard of spondylolisthesis, and even those who have may not have a clear understanding of what the condition is. Simply stated, spondylolisthesis is vertebral misalignment that occurs when one vertebra slips forward over the vertebra beneath it. While this explanation may seem perfectly clear to some, others may have limited knowledge about the spinal anatomy.

So, then, what is a vertebra? Sometimes referred to as the “backbone,” a stack of bone structures called vertebrae house and protect the spinal cord. Most individuals have 33 vertebrae, with nine of them fused in place and 24 of them able to articulate. The fused vertebrae comprise the pelvis and tailbone, while the articulating vertebrae in the neck, middle back, and lower back enable us to bend, twist, and otherwise move about. Facet joints attach a vertebra to the one directly above and beneath it; damage to these joints can lead to the development of spondylolisthesis.

Positioned between each pair of vertebrae is a saucer-shaped pad, called an intervertebral disc. These structures prevent adjacent, articulating vertebrae from rubbing against one another and also serve to absorb the impact that is placed on the spine as it facilitates movement and supports weight. As with facet joints, damage to an intervertebral disc can also lead to spondylolisthesis.

What Causes Spondylolisthesis?

Vertebral misalignment can occur for many reasons, including the presence of spinal tumors, a birth defect, or trauma to the spine. However, more often than not, spondylolisthesis occurs as a result of the natural aging process. This can be explained by the degenerative changes that occur within the facet joints and intervertebral discs, leading to improper support of the vertebrae and the subsequent development of spondylolisthesis.

Facet joints are lined with a thin layer of cartilage that helps to lubricate the joints and allow the joints’ bone segments to comfortably articulate. Over time, this lining can wear away, leading to inflammation of the joints, otherwise known as facet disease or spinal arthritis. Healthy facet joints prevent the spine from bending too far forward and backward, and also limit the degree to which the neck and back can rotate. Arthritic facet joints, however, are less able to control movement and can enable one vertebra to slip forward and over the vertebra beneath it, thus leading to spondylolisthesis.

Intervertebral discs incur similar degenerative changes that can also lead to improper support of the vertebrae and the possibility of vertebral misalignment. The discs’ tough outer shells (annuli fibrosi) tend to become weak and brittle as an individual ages while the gelatinous centers (nuclei pulposi) tend to lose water content. A disc that has undergone these changes is at risk for developing a tear in the annulus fibrosus, which then enables the nucleus pulposus to seep out. This is called a herniated disc. A disc that has been affected by degenerative changes can also become misshapen (appearing to balloon in one direction), which is called a bulging disc. Both herniated and bulging discs can lead to improper support of the vertebrae, which may cause spondylolisthesis.

What are the Symptoms of Spondylolisthesis?

Many individuals who are afflicted with spondylolisthesis remain unaware of any problems in their spines because the condition oftentimes doesn’t cause any symptoms, as may have been the case with you. For the most part, the degree to which the affected vertebra has shifted out of place (which is measured in grades) will dictate the severity of your symptoms:

– Grade 1: 0 to 25% slippage (typically asymptomatic)

– Grade 2: 25 to 50% slippage (mild pain and discomfort)

– Grade 3: 50 to 75% slippage (moderate pain and discomfort)

– Grade 4: 75 to 100% slippage (significant pain and discomfort)

– Grade 5: the vertebra has completely slipped off the one beneath it (severe pain and discomfort that often interferes with a patient’s quality of life)

The most common symptoms associated with spondylolisthesis are pain, muscle stiffness and muscle spasms. Because the lower back (lumbar spine) supports a significant portion of a person’s body weight, and because it facilitates a large amount of movement, it is most prone to degenerative changes, including those that can cause spondylolisthesis. As a result, the condition’s symptoms are most commonly experienced in the lower back, buttocks, and hamstrings, and can become aggravated by activities that strain the lumbar spine. Some individuals (typically those with a higher degree of vertebral slippage) may begin to “waddle” when they walk and may appear to have a protruding abdomen.

Most degrees of vertebral slippage can cause the compression of a spinal nerve, a nerve root, or the spinal cord itself. For many patients with low-grade vertebral slippage, it is a pinched nerve that causes them to experience spondylolisthesis symptoms. Nerve-related symptoms of pain, numbness, muscle weakness, and tingling may be felt in the lower back, hips, buttocks, legs, and/or feet.

How is Spondylolisthesis Treated?

Most individuals who experience low-grade spondylolisthesis will be able to ease their nerve-related symptoms through the use of conservative, nonsurgical treatments. Over-the-counter medications such as naproxen, ibuprofen, and other nonsteroidal anti-inflammatory drugs (NSAIDs) are often recommended to relieve pain and inflammation. Some physicians may prescribe muscle relaxants or narcotic pain relievers for those who are experiencing severe discomfort. Physical therapy, cryotherapy (cold therapy), thermotherapy (heat therapy), massage therapy, and therapeutic ultrasound are also commonly recommended for those with low-grade spondylolisthesis.

Higher grades of spondylolisthesis may require more extensive treatment that involves more than just relieving the symptoms of a pinched nerve. This often entails invasive surgical treatment, which may require the complete removal of some anatomical parts of the spine (namely an intervertebral disc) and/or the fusion of two or more vertebrae. Many patients who undergo these operations face a lengthy and arduous rehabilitation.

Some individuals with low-grade spondylolisthesis may be able to undergo a minimally invasive procedure in lieu of open spine surgery. Visit your spine specialist or other type of physician to find out if you are a candidate for an endoscopic spine procedure.

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