Spondylolisthesis means the slipping of one vertebra over the top of the one below it. The vertebrae are the box-shaped bones that make up the spine.
Normally, the vertebrae are stacked up and aligned with each other. Under certain circumstances, one vertebra may slip forward over the one below. This usually occurs in the lower back area, though the neck can also be affected.
A person with spondylolisthesis often has no symptoms. Those with symptoms may complain of low back pain that is worst when the person is standing, weight-bearing, or playing sports. The pain may spread into the buttocks or thighs.
Inborn defects, injury, or diseases may cause this condition. In adolescents, the most common cause is spondylolysis. In this condition, the bony arch of the vertebra of the low back is abnormally soft and able to slip easily. In the elderly, the most common cause is osteoarthritis in the spine. In this condition, the joints between the vertebrae become worn and unstable.
The following activities increase a person's risk for spondylolisthesis: gymnasticsheavy laborsports, such as footballweight lifting
Sports safety guidelines should be followed for adults, adolescents, and children.
Diagnosis of spondylolisthesis begins with a history and physical exam. Because there are often no symptoms, this condition is often noticed incidentally on X-rays of the lower back.
In mild cases, the person may develop back pain during heavy lifting or sports. In more severe cases, the person may experience greater slipping of the spine and lower back discomfort. Problems with the nerves in the legs may possibly develop. The individual may lose bowel or bladder control.
Spondylolisthesis is not contagious, and poses no risk to others.
Treatment depends on the age of the person, the degree of slip, and the cause. Treatment options for mild cases include: a back braceflexibility and strengthening exercisesgood body mechanicsreduced activity
An operation to fuse the affected vertebrae, called spinal fusion, is considered in serious cases. When the slip is great and there are symptoms of nerve involvement, surgery is often advised.
Like any surgery, spinal fusion can be complicated by bleeding, infection, or reactions to anesthesia. In addition, sometimes it can also result in nerve damage.
The vertebrae may continue to slip despite appropriate treatment.
X-ray tests may be taken every 6 months during adolescence when the body is growing rapidly. Any new or worsening symptoms should be reported to the healthcare professional.