Spondylolisthesis

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The spine moves so much as the body does that there are many back ailments that force the vertebra out of its natural position. Perhaps the most common bone slippage is a slipped disc, but there is also the less common spondylolisthesis. It is important to distinguish between the two as the treatment plan needs to target the cause and any underlying causes.

Spondylolisthesis occurs when one of the bones in the spine, also called vertebra, slip forward over the next bone. While this condition may occur anywhere along the vertebrae, it most often appears in the section called the lumbosacral region, also known as the lower spine.

If left untreated the condition can worsen and cause a permanent deformation of the spine. The risk of the spinal canal narrowing are high when spondylolisthesis goes untreated, which is why it is important to take note of your symptoms and how long they persist prior to your doctor's appointment.

What Causes Spondylolisthesis?

The bones in the spine are held in place by small joints in between them. When a problem develops with one or more of these joints, the bone slides on top of the next bone and that is one of the major causes of spondylolisthesis. There are several main causes of spondylolisthesis, also classified as different types of the condition.

Spondylolisthesis can occur during the developmental phase, in utero or it can be caused by trauma, degeneration or tumors. Knowing which classification of spondylolisthesis you have will allow you and your back specialist to come up with a treatment plan with long-lasting results. Your doctor will type you as having one of the following types of spondylolisthesis:

  1. Isthmic
  2. Degenerative
  3. Congenital
  4. Post-surgical
  5. Traumatic
  6. Pathological

The type you have will determine the best course of treatment.

Symptoms

You may have spondylolisthesis if you suffer from lower back pain, difficulty walking or pain that worsens when you twist or bed. Some patients have pain or numbness in the back, buttocks or legs. In more extreme cases, patients report loss of bladder or bowel control.

While some patients experience muscle spasms, others experience no symptoms at all.

Treating Spondylolisthesis

Before you begin the treatment phase your physician will conduct several different exams to provide an accurate diagnosis. The initial exam will be an external physical exam that will determine if there have been any changes to your gait, posture and mobility. This will determine what the next phase of finding a diagnosis will be.

Imaging will let your back specialist see where any deformities or abnormalities lie on the spine. This may include an x-ray, CT scans, bone scans or MRIs.

Once it has been determined that patient does have spondylolisthesis the physician will likely require that all physical activity comes to a halt, particularly if movement or trauma is the cause of your pain. Pain medication will be prescribed as a temporary measure to stop the pain, and a brace may be given to provide support to the back.

During the regimen of pain medicine, physical therapy and exercise may also be advised to improve muscle strength and flexibility. If these less invasive treatments fail, your doctor may recommend surgery to remove a portion of the bone placing pressure on the spine, called a laminectomy. Spinal fusion is another common surgery to fuse bones together for stabilization.

These surgeries should be a last resort if all other methods fail. Surgery is expensive, risky and will require many foreign elements to be introduced into the body to keep the spine stabilized, thereby increasing the risk of infection.

Talk with your physician and ask questions, to determine the best course of treatment for spondylolisthesis.

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