SPONDYLOLISTHESIS 

Spondylolisthesis is a condition in which one of the bones of the spine (vertebrae) slips out of place onto the vertebra below it. If it slips too much, the bone might press on a nerve, causing pain. This condition usually affects the bones of the  lower back and sometimes the cervical back.

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If you or a loved one suffers from spinal pain, you owe it to yourself to call Southwest Scoliosis and Spine Institute at 214-556-0555 to make an appointment.

Spondylolisthesis Defined

SpondylolisthesisSpondylolisthesis is pronounced spohn-di-low-less-THEE-sis. It refers to a condition in which one of the bones in the spine (vertebrae) slips out of place and pushes on the nerve and nerve roots. It can cause pain, numbness, and tingling in the back, buttocks, and legs. Also, there are many different causes of this condition, including age, injury, and congenital defects. The different types are as follows:

Degenerative Spondylolisthesis

The most common form of spondylolisthesis occurs because of spinal discs that degenerate because of aging. As we get older, the discs between our vertebrae (which usually act as shock absorbers) start to wear out.  When this happens, the facet joints (which keep the vertebra in place) can become awry. As a result, one vertebra may begin to slip over another. So, this condition usually occurs in adults over 40 and more often in women.  right.

Isthmic Spondylolisthesis

This type of spondylolisthesis is related to another condition called spondylolysis.  Spondylolysis involves fractures in the space between two joints where a small bone connects the facet joints.  Also, this type of spinal condition can affect all ages but is usually seen in children and adolescents.  This is due to the fact that their bones continue to grow.

Congenital Dysplastic Spondylolisthesis

This condition results from abnormal bone formation before birth. For instance, congenital spondylolisthesis can lead to stress on the pars interarticularis, causing fractures.

Other, less common forms of spondylolisthesis include:

Traumatic 

Caused by trauma to the vertebrae resulting in a spinal fracture or slipping.

Pathological 

Pathological conditions such as infection, osteoporosis, or even cancer can cause the bones of the spine to become weak, leading to fractures and slippage.

Post-surgical 

As the name suggests, this type of spondylolisthesis occurs or worsens following spinal surgery.

Questions and Answers

What is Spondylolisthesis

Spondylolisthesis is a condition that occurs when one vertebra in the spine slips out of its normal position, usually forward over the vertebra below it. It can occur in the upper, middle, or lower spine, but is most common in the lower back.

What are the Causes of Spondylolisthesis

Spondylolisthesis can be caused by a variety of factors, including birth defects, degenerative changes in the spine, traumatic injury, or repetitive stress from certain sports or occupations. It is most commonly seen in people who participate in sports that involve repetitive hyperextending of the back, such as gymnastics or football.

What are the Symptoms of Spondylolisthesis

The symptoms of spondylolisthesis can vary depending on the severity of the condition and the location of the slipped vertebra. Common symptoms include lower back pain, muscle spasms, stiffness, and weakness in the legs. In severe cases, it can also cause nerve compression, leading to numbness, tingling, or weakness in the legs.

How is Spondylolisthesis Treated

Treatment for spondylolisthesis depends on the severity of the condition and the symptoms that are present. In mild cases, non-surgical treatments such as physical therapy, pain management, and the use of braces or other supportive devices may be recommended. In more severe cases, surgery may be necessary to stabilize the spine and prevent further slippage. Surgical options may include spinal fusion or surgery to relieve pressure on the affected nerves. Your doctor will be able to recommend the best treatment plan for your specific condition.

“It was literally unbearable pain. It was hard to even get on the ground to play with my son. I couldn’t pick him up. I couldn’t carry him around, and it made me feel like less of a mom. So I went to Dr. Hostin and we decided to go ahead with the surgery. I can play with my son now, and that makes me so happy.”    Carrie Grasso

What Causes Spondylolisthesis

There are several factors that can cause the development of spondylolisthesis:

  • Congenital: Some people are born with a defect in the vertebrae that makes them more prone to slipping. 
  • Degenerative: As we age, the discs between our vertebrae can wear down.  This causes the vertebrae to shift and possibly slip out of place.
  • Traumatic: Traumatic injury to the spine, such as a fall or car accident can also cause this condition.
  • Isthmic: This type occurs when a small stress fracture develops in the vertebrae.  This causes the vertebrae to slip out of position.
  • Pathologic: This type of spondylolisthesis is caused by a disease or condition that weakens the bones.  For instance, osteoporosis and bone cancer are two of the diseases.
  • Postsurgical: In some cases, this condition can occur as a result of spinal surgery.

Mild cases of spondylolysis and spondylolisthesis usually cause minimal pain. In fact, the conditions are often found by accident when a person has an X-ray of the back for an unrelated reason.

When spondylolysis and spondylolisthesis do cause pain, you may experience low back pain, stiffness, and muscle spasms. You may also have sciatica (pain radiating down one or both legs), or numbness, though this is not common. Leg pain will usually be worse when you stand or walk.

The amount of pain you have depends on how fast your vertebrae are slipping. If you have very subtle symptoms, you may only feel tightness in your hamstrings or find that you can no longer touch your toes, but not feel any nerve pain.

It’s important to note that a combination of the above factors can also cause spondylolisthesis. The severity can range from mild to severe, and treatment options depend on the cause and extent of the slippage.

Spondylolisthesis Symptoms

Spondylolisthesis creates a range of symptoms that can vary in severity depending on the degree of slippage, the location of the slippage in the spine, and individual factors. Some common symptoms may include:

  • Persistent or intermittent pain in the lower back is a common symptom of this condition. The pain may occur as being dull, aching, or sharp, and may worsen when bending or twisting the spine.
  • Spondylolisthesis can cause pain that radiates from the lower back into the buttocks, thighs, and/or legs. This pain may occur as sharp, burning, or tingling, and may cause weakness or numbness in the legs.
  • The muscles in the lower back may feel tight or stiff.  And there may be a decrease in the range of motion of the spine.
  • The condition can cause changes in the alignment and posture of the spine.  For instance, a patient may have a lordotic curve (swayback) or a flattened lumbar curve.
  • If the slipped vertebra compresses or irritates nearby nerves, it can cause sciatica.  Sciatica is pain that travels down the back of the leg.  It also produces other nerve-related symptoms like weakness, numbness, or tingling in the legs or feet.
  • Spondylolisthesis may alter the way you walk, causing changes in gait or an abnormal walking pattern.
  • The condition can impact your ability to perform daily activities.  Particularly those that involve bending, lifting, or twisting of the spine.

Summary

It’s important to note that not everyone with spondylolisthesis will experience symptoms. Some people with spondylolisthesis may have mild or intermittent symptoms, while others may experience more severe and persistent symptoms. If you suspect you may have spondylolisthesis or are experiencing any of the above symptoms, we invite you to call the Southwest Scoliosis and Spine Institute and make an appointment.

Diagnosis

Diagnosis of spondylolisthesis typically involves a combination of medical history, physical examination, and imaging studies. Here are the steps that our doctors may follow to fully diagnose the condition:

  • The doctor will ask you about your symptoms, including any back pain, numbness, or weakness. Doctors will also inquire about any previous injuries or trauma and any family history of spinal conditions.
  • The doctor will perform a physical examination, which may involve checking your posture, range of motion, and muscle strength. They may also perform tests to assess nerve function by checking reflexes.
  • X-rays are typically the first imaging study used to diagnose spondylolisthesis. X-rays can help identify the presence of slippage, as well as the severity of the condition. Additional imaging studies using MRI or CT scans may also be ordered to obtain more detailed images of the spine and surrounding structures.
  • Spondylolisthesis is classified into different types based on the severity and location of the slippage. The Meyerding classification categorizes spondylolisthesis into five grades (ranging from grade I, the mildest form, to grade V, the most severe).
  • The doctor will also consider other possible causes.  The doctor may rule out other conditions that can mimic spondylolisthesis — disc herniation, spinal stenosis, or facet joint arthritis.

Summary

Finally, based on the medical history, physical examination findings, imaging studies, and classification of the spondylolisthesis, the doctor will make a definitive diagnosis of spondylolisthesis.  The doctor will determine the severity of the condition, and develop a correct treatment plan tailored to a patient’s specific needs.

It’s important to note that diagnosing spondylolisthesis is a complex process that requires the expertise of a spine specialist.  Our Spine Specialists are orthopedic surgeons who will carefully evaluate all the relevant factors to arrive at an accurate diagnosis.

Serious spondylolisthesis sometimes leads to another condition called Cauda Equina Syndrome. This is a serious condition in which nerve roots in part of the lower back called the cauda equina get compressed. It can cause you to lose feeling in your legs. It also can affect the bladder. This is a medical emergency. If left untreated, cauda equina syndrome can lead to a loss of bladder control and paralysis.

Non-Surgical Spondylolisthesis Treatment

Treatment options for spondylolisthesis range from rest, physical therapy, and medication to surgery.  Surgery will depend largely on age, overall health, as well as the severity of the slippage. The most common course of treatment is nonsurgical.

Physical Therapy

Your doctor may have you work with a physical therapist because a well-rounded rehab program assists in calming pain.  However physical therapy will also improve mobility and strength and help with daily activities with greater ease and ability.

Positions, movements, and spondylolisthesis exercises are prescribed to reduce pain. Hamstring flexibility is addressed, along with strength and mobility exercises for the lower back and abdominal muscles. Sports participants benefit from an assessment of their technique and equipment. Also, patients should schedule therapy sessions — two to three times each week for up to six weeks.

The goals of physical therapy are to help you:

  • learn to manage your condition and control symptoms
  • learn correct posture and body movements to reduce back strain
  • maximize your flexibility and core strength

Learn more about spinal rehabilitation.

Medication

Doctors will use medications for short periods to control pain and ease muscle spasms. Medicine will also help regain a normal sleep pattern (if you are having trouble sleeping). Short periods of bed rest may help with acute pain.

Your doctor may prescribe:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs): Medications like aspirin, naproxen, and ibuprofen reduce inflammation and relieve pain.
  • Analgesics: Drugs such as acetaminophen can relieve pain but don’t have the anti-inflammatory effects of NSAIDs.
  • Steroids: These can reduce the swelling and inflammation of the nerves. They are often taken orally in a tapering dosage over a 5-day period and can provide pain relief within 24 hours.

Learn more about medications used to treat back pain.

Steroid Injections

This minimally invasive procedure is performed with x-ray guidance and involves an injection of corticosteroids and a numbing agent into the spine. The medicine is delivered right into the painful area to reduce the swelling and inflammation of the nerves. Repeat injections may be given to achieve full effect, and the duration of pain relief can vary from weeks to years.

Types of injections include:

  • Epidural steroid injections: Delivered into the epidural space of the spinal canal or nerve root canals.
  • Facet injections: Delivered directly into the painful facet joint.
  • Facet rhizotomy: If facet joint injections relieve your pain, an ablation procedure may be performed to “burn” the small nerves around the facet joint to deaden the pain signals.

Holistic Therapy

Some patients find that acupuncture, acupressure, yoga, nutrition/diet changes, and biofeedback are helpful in managing pain as well as improving overall health.

After careful consideration, our doctors may suggest surgery if the usual treatments do not stabilize the spine and relieve the pain and swelling.

Surgery for Spondylolisthesis

After careful consideration, our doctors may suggest surgery If the usual treatments do not stabilize the spine and relieve the pain and swelling.Surgery may be considered for the treatment of spondylolisthesis if conservative measures do not work.  For instance, if physical therapy, pain medication, and activity modification do not effectively relieve the pain. The specific surgical procedure used to correct this condition depends on various factors.  Those factors include the severity of the slippage, the location of the spondylolisthesis in the spine, and the overall health of the patient.

Here are some commonly used surgical procedures:

  • Decompression surgery: This type of surgery involves removing or relieving pressure on the nerves that may be compressed by the slipped vertebra. Examples of decompression surgeries include removing parts of the vertebrae or other structures to create more space for the nerves.
  • Spinal fusion: This is a surgical procedure in which two or more vertebrae are permanently fused together.  This will stabilize the spine and prevent further slippage. The surgeon may use bone grafts, metal screws, rods, plates, or cages to hold the vertebrae in place.  This will aid the healing process.
  • Instrumented fusion: This is a type of spinal fusion that involves using additional instrumentation, such as pedicle screws, rods, or plates, to provide additional stability to the spine during the fusion process.
  • Interbody fusion: This is a type of fusion that involves removing the intervertebral disc between two vertebrae and filling the space with a bone graft or an implant, such as a cage, to promote fusion and stability.
  • Reduction surgery: In some cases, if the slippage is severe, reduction surgery may be performed to manually reposition the slipped vertebra back into its normal position before stabilizing it with fusion. This may involve techniques such as anterior lumbar interbody fusion (ALIF), posterior lumbar interbody fusion (PLIF), or transforaminal lumbar interbody fusion (TLIF).

The Surgical Approach

The surgical approach, technique, and instrumentation used will vary depending on the specific needs of the patient and the expertise of the surgeon (The surgeons at the Southwest Scoliosis and Spine Institute are rated among the best in the world).  Recovery after surgery will also depend on the type of procedure performed and the individual patient’s condition and may involve a period of rehab, physical therapy, and activity changes to allow for proper healing and return to normal activities.

It’s important to note that we at the Southwest Scoliosis and Spine Institute believe that surgical treatment for spondylolisthesis is typically considered after conservative measures have been tried and the symptoms persist.  Furthermore, the patient’s decision to undergo surgery should be made in consultation with a spine surgeon after a thorough evaluation.  Also, after the patient thoroughly discusses the potential risks and benefits.

After Surgery

Patients stay at the hospital for a few days. During this time, they will learn things such as movements to avoid and learn new ways to walk, sit, and stand safely. After the hospital stay, your doctor may choose to put you in a brace to keep the spine properly aligned. Full recovery generally takes 3-6 months and depends largely on factors such as age, overall wellness, and the severity of your condition.

Most patients with minor to moderate spondylolisthesis typically recover within 8-12 weeks with a nonsurgical treatment approach. In addition, there are steps you can take to decrease your risk of developing this condition. Maintaining a healthy weight is the best thing you can do, and exercises that strengthen the back and abdominal muscles can help a great deal. Try to choose activities that don’t put as much stress on the lower back, such as swimming, biking, and stretching/core-building exercises such as yoga, tai chi, or Pilates.

Choosing a Spine Surgeon

The Southwest Scoliosis and Spine Institute is a private medical practice located at three locations in Dallas, Plano, and Frisco, Texas. The practice specializes in the diagnosis and treatment of spinal conditions, including scoliosis, kyphosis, and other spinal deformities. Furthermore, the Institute offers a variety of treatment options, including surgical and non-surgical approaches.

The Southwest Scoliosis and Spine Institute maintains a team of highly experienced and skilled spine surgeons.  These doctors have received specialized training in the diagnosis and treatment of spinal conditions. Therefore, they use the latest techniques and technologies to ensure the best possible outcomes for their patients.

The Institute’s approach to spine treatment centers on the patient, meaning that the doctors and staff approach each patient differently. Moreover, they work closely with their patients to understand their individual needs and goals and develop a customized treatment plan that takes into account the patient’s unique situation, lifestyle, and preferences.

The Institute also offers comprehensive follow-up care and support to its patients.  This includes physical therapy and rehab to help them recover quickly and fully from their surgery.

Spondylitis, Spondylolysis, and Spondylolisthesis

Spondylitis, spondylolysis, and spondylolisthesis are all conditions that affect the spine. However, they are different conditions with different causes, symptoms, and treatments.

Spondylitis

Spondylitis is an inflammatory condition of the spine. It can be caused by a number of factors, including infection, autoimmune diseases, and trauma. Spondylitis can cause pain, stiffness, and inflammation in the spine. It can also lead to other problems, such as spinal deformities and nerve damage.

Spondylolysis

Spondylolysis is a stress fracture in the pars interarticularis, a small piece of bone that connects two vertebrae. It is most commonly caused by repetitive stress on the spine, such as from sports or heavy lifting. Spondylolysis can cause pain in the lower back, especially when standing or walking. In some cases, it can lead to spondylolisthesis.

Spondylolysis (spon-dee-low-lye-sis) and spondylolisthesis (spon-dee-low-lis-thee-sis) are separate yet related conditions. The term "spondylo" means spine, and "lysis" means to divide. Spondylolysis is a breakdown or fracture of the narrow bridge between the upper and lower facets, called the pars interarticularis. It can occur on one side (unilateral) or both sides (bilateral) and at any level of the spine but most often at the fourth or fifth lumbar vertebra.

If spondylolysis is present, then you have the potential to develop spondylolisthesis. Spondylolisthesis is a condition in which one vertebra slips forward over another. It can be caused by spondylolysis, trauma, or other factors. Spondylolisthesis can cause pain in the lower back, as well as numbness or tingling in the legs. In severe cases, it can lead to nerve damage and paralysis.

The term "listhesis" means to slip forward. It occurs when the weakened pars interarticularis separates and allows the vertebra to move forward out of position, causing pinched nerves and pain. Spondylolisthesis usually occurs between the fourth and fifth lumbar vertebra or at the last lumbar vertebra and the sacrum. This is where your spine curves into its most pronounced "S" shape and where the stress is heaviest.
Slippage is measured on a scale from grade 1 slippage (25%) to grade 4 (100%). The more the lower back curves in (swayback or lordosis), the steeper the grade.

Spondylolisthesis

Spondylolisthesis is a condition in which one vertebra slips forward over another. It can be caused by spondylolysis, trauma, or other factors. Spondylolisthesis can cause pain in the lower back, as well as numbness or tingling in the legs. In severe cases, it can lead to nerve damage and paralysis.

The treatment for spondylitis, spondylolysis, and spondylolisthesis depends on the severity of the condition. Mild cases may be treated with rest, pain medication, and physical therapy. More severe cases may require surgery.

Here is a table that summarizes the key differences between spondylitis, spondylolysis, and spondylolisthesis:

               Condition            Cause                                          Symptoms Treatment
Spondylitis Inflammation Pain, stiffness, inflammation, spinal deformities, nerve damage Medication, physical therapy, surgery
Spondylolysis Stress fracture Pain in the lower back, especially when standing or walking Rest, pain medication, physical therapy, surgery
Spondylolisthesis Vertebrae slip forward Pain in the lower back, numbness or tingling in the legs, nerve damage, paralysis Rest, pain medication, physical therapy, surgery

If you are experiencing any of the symptoms of spondylitis, spondylolysis, or spondylolisthesis, it is important to see a doctor for diagnosis and treatment.

The Benefits of the Southwest Scoliosis and Spine Institute

By offering clear, concise information about a spinal condition, the website will help its patients better understand their symptoms.  In addition, it will help patients seek appropriate medical attention, and make informed decisions about their treatment options.

In a larger sense, the webpage addresses the problem of finding information in one place about spinal conditions.  Therefore, when all the information is in one place, can make better informed decisions about their health care. By providing accurate and up-to-date information about spondylolisthesis, this website helps improve overall awareness of spinal health issues and encourages individuals to take proactive steps to address their symptoms.

The long-term benefits of this web page will include improved quality of life for individuals who suffer from spondylolisthesis, as well as reduced healthcare costs and improved public health outcomes. By empowering individuals to take control of their health and seek appropriate treatment, the Southwest Scoliosis and Spine Institute hopes to reduce the long-term impact of spinal conditions on people, families, and society as a whole.

Conclusion

For people who need spine treatment and want the very best, they may want to consider The Southwest Scoliosis and Spine Institute.  Finally, wanting and getting the very best spine doctors is just a phone call away, as among our peers, we are known to be the very bestSo, the reason for contacting us appears simple: Lastly, we specialize in the diagnosis and treatment of spinal conditions, offer a range of treatment options, maintain a highly experienced team of spine surgeons, and take a patient-centered approach to treatment. As with any medical decision, patients need to do their own research, consult with their doctor, and make informed decisions based on their health and individual needs.

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American Academy of Orthopaedic Surgeons: Spondylolisthesis
Healthline: Spondylolisthesis

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