Why Is Spondylolisthesis In The Lower Back So Common?
Spondylolisthesis in the lower back is far more common than spondylolisthesis in the cervical or thoracic regions, largely because the lumbar spine is very flexible, supports a large amount of weight, and is, therefore, more prone to degeneration over time. When a lumbar vertebra (usually the L4 or L5) slips forward and over the vertebra beneath it, the bone can come into contact with spinal nerves, the spinal cord, or the annular wall of an adjacent intervertebral disc. It is this neural compression that ultimately causes symptoms of pain, tingling, numbness, and weakness in the lower back, buttocks, hips, legs, feet, and toes. Tight hamstrings, a modified gait, joint instability, and posture problems can also result from spondylolisthesis in the lower back.
Spondylolisthesis in the Upper Back and Middle Back
While spondylolisthesis is most common in the lower back, the condition does occur, albeit rarely, in the cervical spine (neck). While degenerative vertebral slippage mostly affects the lumbar spine, the neck is more prone to injury-related spondylolisthesis. Fractures can develop in any of the seven cervical vertebrae due to car accidents, overexertion, improper use, and athletic injuries, among others. Symptoms include pain, tingling, numbness, and weakness in the neck, upper back, shoulders, arms, hands, and fingers.
The vertebrae of the thoracic (middle) spine can also develop spondylolisthesis, but are less prone than those of the cervical and lumbar regions because these bones have the added protection and stability of the attached rib cage and are, therefore, less prone to shifting, degeneration, spinal arthritis, bone spurs, and disc degeneration.
The Various Causes of Spondylolisthesis in the Back
Spondylolisthesis treatment largely depends on the underlying cause of the vertebral slippage, which is why the condition is categorized according to its cause:
– Type I refers to congenital spondylolisthesis (a birth defect) caused by a malformation of the articular bones of the facet joints.
– Type II is spondylolisthesis caused by a fracture of the “pars,” short for the pars interarticularis, which is the section of bone between the lamina and transverse processes.
– Type III is the result of degeneration due to aging, spinal arthritis, or disc deterioration.
– Type IV involves a vertebral fracture that is not in the pars interarticularis.
– Type V is caused by spinal tumors that have developed in and weakened the spinal anatomy.
– Type VI is a form of FBSS (failed back surgery syndrome), which means the vertebra has shifted forward due to post-surgical complications.
Grades of Spondylolisthesis
Once your doctor has confirmed the cause of your spondylolisthesis, regardless of which region of the spine the vertebral slippage is located in, he or she will then conduct diagnostic imaging tests to determine how severe the slippage is. A Grade 1 or 2 (less than 50 percent of the vertebra has slipped forward) is considered mild to moderate and may not present spondylolisthesis symptoms. Grades 3 and 4 indicate 75-100 percent slippage, which is severe. Most doctors will suggest a regimen of conservative treatment for any degree of spondylolisthesis before the option of surgery is discussed, and only a small percentage of individuals with the condition will ever require an operation.
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 spondylolisthesis and several other spinal conditions.
Category: Medical Business
Keywords: Spondylolisthesis