What is Spondylolisthesis?
Spondylolisthesis is a defect or fracture of part of the vertebral bone called the pars interarticularis. It usually occurs in the lumbar region. Spondylolisthesis (Low Back) is a forward slippage of one vertebral body on top of another.
Spondylolisthesis are of two type :
1) Developmental – This is due to defect or weakness in the bony restraints from birth. When the defect is more it presents as high grade listhesis in early teens. When the defect is less it presents at 30 to 40 years as low grade spondylolisthesis.
2) Acquired Causes are the other group of causes due to trauma following surgery or disease etc.
What are the symptoms of spondylolisthesis?
Most people with spondylolisthesis have slow onset of symptoms. The common symptoms may include:
• Low back pain
• Feeling of tightness in the back of thighs
• Pain radiating down the legs
• Difficulty with upright posture and gait
Why do patients with spondylolisthesis have pain?
Patients have pain in the back because of the unstable movement of the vertebra. Leg pain is because of pressure on the nerves.
What is the treatment for spondylolisthesis?
The patient may be treated surgically or non-surgically. Treatment can only be decided after thorough examination and investigations. Every patient will have to be individually evaluated and after considering the extent of the spondylolisthesis, age of the patient, presence of medical conditions and expectations of the patient. Only then can a treatment protocol be decided.
What is the non-operative treatment of Spondylolisthesis?
Most patients with spondylolisthesis have acute episodes of pain with intervening pain free periods.
These symptoms usually improve with rest and time.
To help relieve the pain, treatment may include:
• Pain killers
• Belts/ braces
Patients may also be given a small injection (epidural steroid) into the spine for pain relief.
When is surgery required?
Patients who have one or more of the following symptoms may require surgery.
• Worsening of back pain or persistent leg pain with no improvement even with adequate rest and pain killers.
• Weakness of the legs,
• Disturbance of bowel or bladder function
• Progressive forward slipping of the vertebra.