Spondylolisthesis is the anterior, or forward, displacement of one vertebra over another. Retro spondylolisthesis, or posterior displacement, is also possible, but is not as common. The condition occurs most often in the lumbar spine (lower back) because this region of the spine is extremely flexible, supports a large amount of weight, and is more prone to degeneration over time than are the cervical (neck) and thoracic (middle back) regions of the spine.

Spondylolisthesis causes include traumatic injury, disease (Paget’s disease, metastatic tumors, or bone disease), congenital disorders, and degeneration. Deterioration over time, a natural part of the aging process, is by far the most common cause of spondylolisthesis, especially in patients with spinal arthritis. As the facet joints – hinge-like structures that allow adjacent vertebrae to articulate – deteriorate, bone spurs can develop, a process often referred to as “facet remodeling.” As the facet joint “remodels” itself, a vertebra may be forced forward slightly.

Symptoms of Spondylolisthesis

Spondylolisthesis symptoms will vary from patient to patient, but the most common area for the condition to occur is between the fourth and fifth lumbar vertebrae, L4 and L5. While the majority of patients with degenerative spondylolisthesis in the lower back will not exhibit symptoms, a small percentage of individuals may have symptoms of pain, tingling, numbness, and/or weakness in the lower back, buttocks, legs, feet, and toes. This discomfort can remain stationary, or it can radiate through the lower extremities. Symptoms are ultimately due to the compression of one or more spinal nerve roots (or the spinal cord itself) by the displaced vertebra or surrounding tissue.

Treatments for Spondylolisthesis

If you are experiencing symptoms, spondylolisthesis treatment will generally depend on the degree of vertebral slippage. If the slippage is mild to moderate (less than 50 percent of the vertebra protruding over the vertebra beneath it) and non-progressive, you may be able to find relief from conservative treatments like pain medication, bracing, stretching, physical therapy, and periods of rest, though the vertebra is not likely to retract or move back into place on its own. In the case of severe spondylolisthesis (more than 50 percent vertebral protrusion), your doctor may recommend surgery as a treatment option.

Spondylolisthesis Surgery

The aim of spondylolisthesis surgery is to relieve neural compression caused by the displaced vertebra and surrounding elements of the spine such as intervertebral discs. In the rare case that displacement is caused by injury, surgery could just be a matter of realigning the spine.

However, degenerative spondylolisthesis is more complicated. Because the patient’s spine has likely acclimated to the displacement, suddenly forcing realignment through surgery could be detrimental to the vertebrae and intervertebral discs above and below the site of slippage. Another feature of spondylolisthesis surgery that can pose risks is spinal fusion, which requires a bone graft and stabilizing hardware to permanently fuse two vertebrae together. While this will likely mitigate neural compression and prevent future slippage, the patient will lose mobility in that segment of the spine. Minimally invasive procedures that do not require fusion are available, but before you decide on any type of surgery, it’s best to talk extensively with your doctor about why he or she is recommending surgery, get second and third opinions, and do your own research about the benefits and risks of each type of surgical procedure.

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