Spondylolisthesis is a condition in which a bone (vertebra) in the spine slips out of the proper position onto the bone below it. Forward slippage of one vertebra on another is referred to as anterolisthesis, while backward slippage is referred to as retrolisthesis. Though it can occur at the level of cervical vertebrae, it occurs most often at the level of the lumbar vertebrae. Spondylolisthesis usually occurs between the fifth bone in the lower back (lumbar vertebra) and the first bone in the sacrum (pelvis) area (L5-S1)
Major types of lumbar spondylolisthesis:
- Congenital spondylolisthsis
- Traumatic spondylolisthsis
- Degenerative spondylolisthesis
- Pathologic spondylolisthesis
What are the symptoms of spondylolisthesis?
- Lower back pain
- Stiffness in the back
- Localized pain or tenderness in the back just above the pelvis
- Muscle tightness, tight hamstrings
- Pain in the thighs and legs (radiculopathy)
- Pain, numbness, or tingling in the thighs and buttocks
- Tenderness in the area of the slipped disc
- Weakness of muscles in one or both legs
How is spondylolisthesis diagnosed?
- PET scan
X-rays of the lower back (lumbar) spine will show the position of the vertebra. Follow-up x-rays are needed to make sure the problem is not getting worse.
The conservative treatments:
- Physical therapy – Stretching and strengthening exercises for the back and abdominal muscles can help prevent future recurrences of pain. Physical therapy can also help to increase range of motion of the lumbar spine and hamstrings as well as strengthen the core abdominal muscles.
- Lifestyle modifications – You may be asked to avoid contact sports or to change activities to protect your back from being overextended.
- Anti-inflammatory medications can help reduce pain by decreasing the inflammation of the muscles and nerves.
Surgery may be needed if slippage progressively worsens or if back pain does not respond to conservative treatment and begins to interfere with activities of daily living. The type of surgery is based on the type of spondylolisthesis.