Spondylolisthesis

Description

Spondylolisthesis describes the slight slipping of one vertebral body over another. It typically occurs in the lumbar spine.

Causes

Birth defects, injuries, and a rapid growth spurt during adolescence can cause spondylolisthesis. Rigorous sports such as football, weightlifting and gymnastics can also lead to this condition. Spondylolysis is a condition involving a fracture or fractures of the vertebral bodies. It can also result in spondylolisthesis. Degeneration due to age, tumors, and surgery are possible causes as well.

Symptoms

Symptoms vary with the degree of spondylolisthesis. Pain, stiffness and muscle spasms are frequent. Radiculopathic symptoms such as numbness, tingling, and weakness may occur in the legs. Significant pressure on spinal nerves may result in cauda equina syndrome. This can result in the loss of bowel and bladder control and is a surgical emergency.

Diagnosis

The diagnosis of spondylolisthesis is established though a history and physical exam, followed with diagnostic imaging which can include X-rays in multiple positions including flexion, extension and standing. A CT scan, an MRI or a CT myelogram may also be ordered by the physician.

Management

Treatment for most cases of spondylolisthesis is non-surgical. Rest, back braces, physical therapy and chiropractic care are the mainstays of conservative treatment. Medications to relieve pain and muscle spasms and assist with sleep may be prescribed by your physician. If conservative measures do not result in an appreciable improvement of symptoms, epidural steroid injections can be performed by an appropriately trained physician such as an interventional pain management doctor. Significant nerve compression may have to be addressed with a decompressive laminectomy. Spinal fusion surgery may have to be attempted to correct significant spinal instability.