Spondylolisthesis: Causes, Symptoms, Diagnosis, and Treatment
What Is Spondylolisthesis?
Spondylolisthesis is a spinal condition where one vertebra slips forward over the one beneath it. This displacement can cause significant discomfort, nerve compression, and mobility issues. The severity ranges from mild to severe, with some cases requiring surgical intervention.
Types of Spondylolisthesis
There are several types of spondylolisthesis, classified based on their cause:
Congenital Spondylolisthesis – Present at birth due to abnormal spinal formation.
Isthmic Spondylolisthesis – Caused by a small fracture in the pars interarticularis, commonly seen in athletes.
Degenerative Spondylolisthesis – Resulting from aging and spinal degeneration, usually affecting older adults.
Traumatic Spondylolisthesis – Occurs due to injury or trauma that weakens spinal structures.
Pathologic Spondylolisthesis – Caused by diseases such as osteoporosis or tumors affecting the spine.
Post-Surgical Spondylolisthesis – A complication from previous spinal surgery.
Causes and Risk Factors
Spondylolisthesis can develop due to various factors, including:
Genetic predisposition – Some individuals are born with structural weaknesses in the spine.
Repetitive stress – High-impact activities such as gymnastics, football, and weightlifting.
Aging – Wear and tear over time leading to spinal instability.
Injury – Sudden trauma or fractures to the vertebrae.
Degenerative conditions – Arthritis and disc degeneration contribute to spinal instability.
Symptoms of Spondylolisthesis
Symptoms vary based on severity and affected spinal level, including:
Lower back pain – The most common symptom, worsened by activity.
Sciatica – Pain radiating down the legs due to nerve compression.
Tingling or numbness – Especially in the legs and feet.
Weakness in the lower limbs – Difficulty walking or standing for long periods.
Muscle tightness – Particularly in the hamstrings.
Postural changes – Increased curvature of the lower spine (lordosis or swayback).
Diagnosis
To diagnose spondylolisthesis, doctors use:
Physical examination – Evaluating flexibility, pain levels, and nerve function.
X-rays – Identifying vertebral slippage.
MRI or CT scans – Providing detailed images of spinal nerves and soft tissues.
Grade Classification – Measured using the Meyerding scale:
Grade I: 0-25% slippage
Grade II: 26-50% slippage
Grade III: 51-75% slippage
Grade IV: 76-100% slippage
Grade V (Spondyloptosis): Complete vertebral slippage
Treatment Options
Treatment depends on severity, symptoms, and patient lifestyle.
Non-Surgical Treatments
Physical Therapy – Strengthening core muscles to support the spine.
Pain Management – NSAIDs, muscle relaxants, and epidural steroid injections.
Bracing – Wearing a lumbar brace to stabilize the spine.
Lifestyle Modifications – Avoiding heavy lifting and high-impact activities.
Surgical Treatments
Surgery is recommended for severe cases or when conservative treatments fail. Procedures include:
Spinal Fusion – Fusing two vertebrae to prevent further slippage.
Laminectomy – Removing part of the vertebra to relieve nerve pressure.
Instrumented Fixation – Using screws and rods for stability.
Prevention Tips
Maintain a healthy weight – Reducing pressure on the spine.
Exercise regularly – Strengthening core and back muscles.
Use proper lifting techniques – Preventing spinal injuries.
Stretching routines – Enhancing spinal flexibility and mobility.
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