What is Spondylolisthesis?
The spinal column, with its stack of vertebrae and cushioning spinal discs, is a wonder of form and functionality. But the spinal column is also prone to numerous problems that can occur should one or more of the vertebrae become improperly positioned. Spondylolisthesis refers to a condition where vertebrae in the spine are malpositioned. From Greek, it translates to “vertebra” and “slipperiness.” In spondylolisthesis, a vertebra slips over the vertebrae located directed it below, and typically it slips forward. (This condition is not to be confused with what is often called a “slipped disc” a common term for “herniated disc,” which we recently blogged about.) Spondylolisthesis occurs most commonly in the lumbar, or lower portion of the spine. There are two main types of spondylolisthesis, spondylolytic (also know as lytic) and degenerative. Athletes such as weightlifters, gymnasts, and football linemen place tremendous stress on their lower backs and are at increased risk to develop vertebral stress fractures on the right and left sides of a vertebra. Untreated, these “lytic” fractures may not heal and can lead to instability, which may cause the bones and vertebrae to shift out of place. Spondylolisthesis can also develop as a normal part of aging, secondary to degenerative disc and joint disease such as arthritis. Spinal stenosis often accompanies spondylolisthesis. A third type of spondylolisthesis is present at birth and is referred to as being a “congenital” condition.
Symptoms of lumbar spondylolisthesis include soreness in the area of the slippage, tightness or stiffness of the muscles of the lower back, pain in the lower back, thighs and buttocks, and sciatica. In addition to these symptoms, over time numbness and weakness in one or both legs may develop. The severity of the condition and the vertebral slippage is measured on a lateral lumbar x-ray using a specialized system called the Meyerding grading system, ranging from Grade 1 (up to 25 percent slippage off the lower supporting vertebrae) to Grade 4 (75 to 100 percent slippage). Treatment for spondylolisthesis is based on the severity of the condition and may include activity modification, exercise, medications, physical therapy, physical modalities including heat, electrical stimulation, and ultrasound, lumbar traction, chiropractic care, lumbar epidural injections, a back brace, and in severe cases, spinal surgery. In addition to the standard surgical procedures which include laminectomy and fusion, more minimally invasive surgery including lumbar interspinous process distraction and stabilization surgery may be a safe and effective treatment option for appropriately selected patients. Here at New Jersey Spine Specialists with offices located in Summit and Montclair, our comprehensive experience with all spinal therapies and advanced treatments has provided many patients with excellent results. We invite you to contact our office and schedule a consultation to learn what options are available specifically for you.