Degenerative Spondylolisthesis

Spondylolisthesis is partially genetic in nature, so you are at a greater risk for developing this condition if a member of your direct family (parents, grandparents, or siblings) has it. Lifestyle also plays a big part, but it can be brought on by any the following:

• • • Aging, which causes wear and tear on the bones and nerves of the spine
    • Engaging in high-impact sports, such as football or gymnastics, that overextend the spine
    • Bone diseases that cause structural deformities
    • A spinal fracture (or other injury) that results in complications or heal incorrectly

Women are more at risk for this condition than men are. Degenerative Spondylolisthesis is more often diagnosed in adults over the age of 50, which will typically occur as a part of aging. However, if children or adolescents experience symptoms of spondylolisthesis, the slippage is most likely due to overextension of the spine associated with sports or other activities. In children, this condition is called isthmic spondylolisthesis.

Many people confuse spondylolisthesis with another spinal condition called spondylosis. Spondylosis is a similar disease that is solely age-related and causes the bones in the spinal canal to degenerate. Spondylosis is the aging process of the spine, but what results are diagnoses such as degenerative disc disorder or osteoarthritis of the spine.

Many people with this condition may not experience spondylolisthesis symptoms, so it’s often noticed when doctors are looking at imaging for other diagnostic purposes. It is commonly known that an x ray is best to diagnose and identify a spondylolisthesis, so this may be what your doctor initially orders if they suspect that’s the issue at hand.

However, spondylolisthesis can be difficult to notice on imaging tests, so doctors may need to use more than one imaging test to confirm the presence of a misplaced vertebra. If they begin by performing a magnetic resonance imaging (MRI), they may also use a simple x ray or computed tomography (CT) scan to give them a better picture of the health of your spine.

If someone is experiencing discomfort and symptoms from a lumber spondylolisthesis, doctors will complete a test called the Low Midline Sill Sign Test. This involves looking at the outward appearance of the lumbar spine.

If the doctor sees the small spinous processes (bumps on the back side of the vertebrae) form the shape of an uppercase L between the middle and lower back, this typically indicates the presence of spondylolisthesis.

Each person with spondylolisthesis will exhibit different symptoms and some people may not experience issues at all. However, spondylolisthesis is generally known to cause some of the following symptoms:

• • • Excess tightness in the hamstrings, which are a group of muscles located on the back of the thighs
    • Muscle spasms of the hamstrings (which feel like painful, pulsating contractions)
    • Stiffness of the low back
    • Generalized low back pain when bending, kneeling, stooping, or doing anything that places an arch in the back
    • Muscle weakness, especially affecting the joints in one or more feet
    • Numbness or tingling, known as a feeling of pins and needles, in the legs or feet (this results when the displaced bone places pressure on a nerve)
    • Trouble walking or standing for extended periods of time
    • Lower back pain

Low-grade spondylolisthesis (also known as Grades I and II) responds very well to a combination of rest, stretching, and medication. The best way to treat spondylolisthesis at this stage is with chiropractic or physical therapy.

Chiropractors can help stop the degenerative changes to the spine by offering treatments such as manipulative therapy, flexion distraction, and intersegmental traction.

Each of these modalities can serve to ease stiffness, restore proper joint motion, and relieve pain that may result from spondylolisthesis. Functional strengthening exercises may be recommended to decrease stress on the segment affected by the spondylolisthesis.

High-grade spondylolisthesis (Grades III and IV) may require surgery if you are in significant pain and having extreme difficulty walking or getting around on a daily basis. The recommended surgery is called spinal decompression.

This procedure relieves pressure on the nerves in the spinal canal, since this is typically where severe spondylolisthesis pain stems from. In some cases, this surgery may also involve spinal fusion, which is when the surgeon uses metal hardware (such as rods, screws, or plates) to permanently connect two spinal vertebrae together.

This alleviates issues caused by a vertebra being in the wrong place and keeps them properly aligned, so shifting bones do not put pressure on the nerves in the spinal cord. It is usually recommended to seek conservative care treatment before seeking spondylolisthesis surgery.