Spine Surgery

November 13, 2015

Does Your Spondylolisthesis Require Spine Surgery?


Treatment for spondylolisthesis typically involves physical therapy, pain medication, and other nonsurgical options. However, in some cases spinal fusion surgery can offer a more effective solution for your severe, ongoing back pain. 

Spondylolisthesis occurs when a vertebrae (or spinal bone) moves out of position and rests on the bone below it, placing pressure on one or more nerves. This condition is a common cause of back pain that can interfere with your day-to-day activities. Neurosurgeons usually recommend nonsurgical spondylolisthesis treatment at first, but if those options fail, you may need spinal fusion surgery.

Symptoms of Spondylolisthesis
Spondylolisthesis does not always cause noticeable symptoms. However, if you do notice symptoms they will most likely present themselves as:

  • Lower back pain
  • Muscle spasms in your hamstring, or back part of your thigh
  • Pain that extends down your leg
  • Tingling in your foot

If you notice any of these symptoms—especially if they occur simultaneously—you may want to ask your orthopedic surgeon about spinal fusion surgery to treat your spondylolisthesis.

Signs That You Need Spondylolisthesis Surgery 
When pain from spondylolisthesis does not diminish with conventional treatment methods, such as physical therapy or a back brace, spinal fusion surgery may be your best option. Some cases of isthmic and degenerative spondylolisthesis that do not respond to nonsurgical forms of treatment respond well to spinal fusion surgery, which can help reduce your pain and other symptoms.

Isthmic spondylolisthesis occurs when a vertebra slips out of position due to spondylolysis—a condition that causes spinal fractures. Degenerative spondylolisthesis occurs when one or more spinal bones move out of position as they weaken with age. If you experience persistent or severe pain associated with either type of spondylolisthesis, discuss your surgical options with a neurosurgeon.

In most cases, your doctor will try conventional treatment for roughly six months before considering spinal fusion surgery. Your spine surgeon may also recommend surgery when spondylolisthesis presses on one or more nerves, which can cause increased pain, numbness, and tingling.

Types of Surgery for Spondylolisthesis
There are several types of spinal fusion surgery available to treat spondylolisthesis. The aim of these procedures is to stabilize your spine and reduce pain:

Posterior Fusion
During this type of spinal fusion surgery, your surgeon will approach the affected area from the back. A piece of your pelvic bone will be removed and placed between your slipped vertebrae, allowing them to fuse to the spine and form a stable piece of bone.

In some cases, cadaver bone will be used instead of, or in supplement to, you pelvic bone. It is up to your orthopedic surgeon’s preference, so be sure to discuss your options and comfort level with your surgeon. In some cases, screws and rods are inserted to hold the bones together until they fuse.

Anterior Lumbar Interbody Fusion
This type of spine surgery involves approaching the affected area of your spine through the abdomen, which offers a larger surface area for the procedure. Anterior fusion surgery is usually preferred for treating spinal deformities caused by isthmic spondylolisthesis. Like posterior spinal fusion surgery, anterior fusion involves placing a piece of pelvic bone between spinal bones and allowing them to fuse to your spine.

Posterior and Transforaminal Lumbar Interbody Fusion
This type of spinal fusion surgery involves approaching the affected area through the lower back, although the surface area is limited when using this technique. Posterior transforaminal fusion is best used to treat localized spondylolisthesis located in the lower back.

As with other types of spinal fusion, surgeons place a piece of bone from the pelvis—or cadaver bone—between spinal bones and give them time to fuse to the spine. However, the rods or other fixation devices used must be small with this type of surgery due to the limited surface area.

Discuss your spondylolisthesis treatment with your spine surgeon and ask if they recommend spinal fusion surgery. If you do require spine surgery, be sure to ask about any preparations you will need to make for your recovery.

If you need more information on spondylolisthesis treatment in Arkansas, contact Arkansas Surgical Hospital at 877-918-7020 to schedule an appointment with one of our experienced neurosurgeons.

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