What is Spondylolisthesis?

The spine condition, spondylolisthesis is a result of one of the vertebrae in your spinal columns slipping out of place or alignment onto the vertebra below it. The word spondylolisthesis comes from the Greek words spondylos, meaning “spine or vertebra, “ and listhesis, meaning “to slip or slide.” If the vertebra slips too far, it could press on a spinal nerve and cause low back pain, numbness or weakness in one or both legs. In rare cases, it may even lead to losing control over your bladder or bowel. If this severe condition happens your should seek medical attention immediately.

What Causes Spondylolisthesis?

The spine is made of vertebrae and each one is joined together by small joints called facets, which lines up the vertebrae and allows you to bend, twist and turn. Spondylolisthesis is caused when one or more of these facet joints become degenerative, weak or fractures allowing for the vertebrae to move or slip to some degree. Main causes of spondylolisthesis are:

  • A defective facet joint you have had since birth (congenital)
  • A facet joint damaged by trauma or and accident
  • A stress fracture from overuse of the facet joint
  • An arthritic facet joint or an infection

This condition can affect children and teens that are involved in high impact sports such as gymnastics, weightlifting and football. The high impact and overuse of the backbones and facet joints can cause stress fractures in the vertebrae and can result in spondylolisthesis. Older adults can develop spondylolisthesis because of wear and tear from physically demanding work that leads to fractures. The condition can also occur without fractures because of weakening of the ligaments that connect the vertebrae thus allowing for slippage.

Spondylolisthesis are graded according to how much one vertebra slips compared to the adjacent vertebra:

  • Grade I Less than 25 percent
  • Grade II Between 25 and 50 percent
  • Grade III Between 50 and 75 percent
  • Grade IV More than 75 percent
  • Grade V Spondyloptosis occurs when the vertebra has completely fallen off the next vertebra. 

What are the Symptoms of Spondylolisthesis?

Spondylolisthesis can be present to some degree and the patient never has any symptoms at all. The most common symptoms of spondylolisthesis are:

  • Pain traveling from the low back down on or both legs
  • Numbness or weakness in one or both legs
  • Walking difficulty
  • Back or buttock pain, that gets worse with bending over or twisting
  • Loss of bowel or bladder control

What are the Diagnostic & Treatment Options for Spondylolisthesis?

How is Spondylolisthesis Diagnosed?

A spine-trained physician typically diagnoses Spondylolisthesis. Accurate and thorough diagnosis is key to selecting the best treatment options. The following is part of a comprehensive diagnostic workup:

  • Medical History Assessment of symptoms, previous treatments and care.
  • Physical Examination A careful examination by a spine specialist for limitations of movement, problems with balance, and pain. The examination should also cover loss of reflexes in your extremities, muscle weakness, loss of sensation or signs of spinal cord damage.
  • Diagnostic Tests Generally, plain x-ray films are taken which allows the physician to rule out other problems such as infections. CT scans and MRIs are often used to give them a three-dimensional view of the lumbar spine and can help detect herniated discs.

X-rays of your back can show slippage and or fractures of the vertebrae. Also, a MRI and CT scan can pinpoint the damage and help determine the degree of spondylolisthesis and better guide the treatment plan.

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