Spine Surgery

June 20, 2022

Symptoms & Solutions: Spondylolisthesis

Woman holding her back

Spondylolisthesis is a spinal problem most often diagnosed after a patient complains of lower back pain. When one of the vertebrae in the spine slips out of place, it crushes or pushes on the vertebra beneath it, resulting in pain and, in some cases, limited movement. This is usually the result of overextension of the spine, which may be caused by activities, aging, or a genetic thinning of the bones of the spine.

Symptoms of Spondylolisthesis

The primary symptom of spondylolisthesis is lower back pain caused by spinal instability. The vertebrae are able to move more than they should, and one or more vertebrae slips down over the ones below. This puts pressure on a nerve, triggering back pain and sometimes pain that runs down the leg. However, some patients have spondylolisthesis without ever experiencing symptoms, in which case no treatment is necessary.

The most common symptoms of spondylolisthesis are:

  • Pain in the lower back, buttocks, and thighs
  • Muscle spasms in the back of the thighs
  • Difficulty standing or walking for extended periods
  • Back stiffness
  • Numbness or tingling in one or both feet
  • Pain when bending over

If you have any of these symptoms, it’s essential to talk to someone specializing in spinal problems to discuss your options. Your physician will evaluate your symptoms and may order X-rays, an MRI, or a CT scan to assess your back’s vertebrae, discs, muscle, and tendons.

What Causes Spondylolisthesis?

There are several potential reasons someone might develop this spine problem. In rare cases, an accident or illness such as a spinal tumor or osteoporosis may lead to spondylolisthesis.

The most common form, degenerative spondylolisthesis, is a result of the aging process. As we grow older, stress on our spine, degenerative bone disease, wear and tear, or a herniated disc may lead to a vertebra slipping and compressing a nerve. This is most common in individuals over 50 years of age and is more likely to occur in women.

Some people develop isthmic spondylolisthesis after developing spondylosis, which is a crack or fracture in a vertebra. The crack leads to weakening of the bone, which allows it to slip down and over another vertebra. Infants are occasionally born with a congenital deformity of the spine that may trigger slippage later in life.

Individual risk factors for spondylolisthesis include:

  • Being an adolescent athlete participating in sports involving stretching and twisting the spine, including football and gymnastics. During growth spurts, the spine is more likely to suffer from slippage and cause back pain in teens.
  • Aging, which increases the risk of developing spine problems due to normal wear and tear or repetitive tasks that require a lot of bending or twisting of the spine.
  • Genetic predisposition, particularly if you are born with certain types of spinal deformity.

How is Spondylolisthesis Treated?

For most people, treatment for spondylolisthesis is relatively straightforward and doesn’t require surgery. There are several non-invasive options that may bring relief.

Rest & Bracing

If your condition was caused by overextension while participating in sports or other activities, you might need to take a break to rest your back and let the inflammation subside. You can still exercise, but less strenuous exercises like water aerobics and tai chi are better options.

In some instances, a specially designed brace may be recommended for a child or adolescent with spondylolisthesis. The brace is worn except when resting to provide support and prevent further movement of the vertebrae.

Medication

Over-the-counter medications such as Tylenol, ibuprofen, or naproxen can alleviate pain and minimize swelling in the lower back. If these aren’t effective, your doctor may prescribe stronger pain medications or an anti-inflammatory drug.

Physical Therapy

Physical therapy can provide relief from spondylolisthesis through stretching exercises designed to strengthen the back muscles, support the spine, and stretch tight hamstrings (muscles in the backs of the thighs). A physical therapist also provides patients with exercises and stretches to do at home.

Steroid Injections

If the pain from spondylolisthesis is severe, steroid injections from a pain management specialist may bring relief. These are generally used only if other non-invasive techniques haven’t worked. Relief can last anywhere from a few weeks to a year and is often used before physical therapy to make therapy less painful and more productive.

Who Needs Surgery for Spondylolisthesis?

For some people, none of the non-invasive procedures listed above bring pain relief or restore freedom of movement. In these situations, surgical intervention may be the only option. Surgery is also an option if the slipped vertebra has affected the patient’s posture or limited their movement. Successful surgery for spondylolisthesis will stabilize the spine, relieve pressure on the affected nerve, and restore function.

Spinal decompression, sometimes combined with spinal fusion, is the most common surgery for spondylolisthesis. During decompression, the surgeon removes any damaged discs and bone from the spine, opening up the area around the damaged nerve to relieve pressure. This should alleviate the pain. If needed, the affected vertebrae are fused to prevent them from slipping out of alignment again.

After surgery, walking and gentle, low-impact movement is recommended. About two to three months after your surgery, physical therapy is recommended for several weeks. This focuses on strengthening the core abdominal muscles and improving flexibility. After several months, you may be able to return to former sports and activities.

Get Help for Spondylolisthesis Today

The spine surgeons at Arkansas Surgical Hospital have performed spine decompression surgeries on patients of all ages suffering from spondylolisthesis with impressive results. If you suffer from lower back pain and haven’t found relief, contact us today at (501) 748-8000 to request an appointment.

Photo by Kindel Media from Pexels

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