The condition of one vertebra slipping forward and over the vertebra beneath it is called spondylolisthesis. Causes include congenital defects in which the vertebrae have not formed properly, traumatic injury, disease, and anatomical deterioration. While the end result – anterior (forward) vertebral slippage – is basically the same (regardless of the cause), it is extremely important to know the exact cause of your particular condition to ensure proper treatment.

Natural degeneration that accompanies the aging process is by far the most common of the spondylolisthesis causes, and the condition usually presents in the lumbar (lower) spine, in the region of the fourth and fifth lumbar vertebrae (L4-L5) and the first sacral vertebra (L5-S1). While all the elements of the spinal anatomy experience some degree of degeneration, the wear and tear on the facet joints due to spinal arthritis is usually responsible for spondylolisthesis. The cartilage surrounding the joints wears away, bone spurs develop, and the vertebrae are not held in place as securely as before, hence the possibility of displacement.

The Different Types of Spondylolisthesis

Because it is necessary to understand the cause of a patient’s condition before effective spondylolisthesis treatment can be administered, doctors have cultivated a system for categorizing the different types of spondylolisthesis according to their causes:

– Type I – Congenital spondylolisthesis is caused by a malformation of the articular processes of the facet joints.

– Type II – Isthmic spondylolisthesis is due to injury, involving complete or partial factures of the pars interarticularis (segment of bone between the lamina and transverse process).

– Type III – This is caused by natural degeneration that accompanies the aging process.

– Type IV – A fracture develops in any other part of the vertebra except the pars interarticularis.

– Type V – Weakening of vertebrae due to spinal tumors, possibly causing fractures that sever the posterior (front) and anterior (back) aspects of a vertebra.

– Type VI – Iatrogenic spondylolisthesis occasionally occurs after spinal surgery when the pars have weakened.

Treating Degenerative Spondylolisthesis

Many patients with spondylolisthesis may never even know they have the condition and will not experience symptoms. For those individuals whose condition is causing compression of one or more spinal nerves, the spinal cord, or the annular wall of an intervertebral disc, symptoms of pain, tingling, numbness, and/or weakness may present in the lower back and body. A change in gait, a protruding abdomen, and the development of swayback are also common spondylolisthesis symptoms.

Surgical Treatment

Many forms of Type II and IV spondylolisthesis can be corrected with surgery. In these cases of trauma, the surrounding spinal anatomy has not had a chance to conform to the displaced vertebra, so realigning the vertebrae and allowing the fracture to heal is fairly simple. Degenerative spondylolisthesis, however, can be more complicated to treat. Since vertebral slippage has likely occurred over time and the surrounding bones and discs are also degenerated, forcing the displaced vertebra back into place could cause more harm than good. A doctor will likely begin a treatment regimen with noninvasive techniques, such as hot/cold therapy, medication, bracing, rest, and physical therapy. If weeks or months of conservative treatment prove ineffective, surgery may become a consideration. Talk to your doctor about the surgical options available to you and be sure to get a second, or even a third, opinion.

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