Spondylolisthesis
Spondylolisthesis is a spinal deformity caused by the slippage of one vertebrae over another. It can be very painful, especially in when doing activities that involve a lot of forward and backward bending of the trunk.
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What is Spondylolisthesis?
Spondylolisthesis occurs when one of the vertebrae, the bones in your spine, slips forward, it can cause lower back pain. It usually happens at the base of the spine.
Spondylolisthesis may appear in children as the result of a birth defect or injury. Genetics may also play a part as some people are born with thinner vertebral bone.
In older adults, spondylolisthesis is often the result of wear and tear on the cartilage and bones. This can be made worse by conditions such as arthritis, injury from an accident or the result of a fracture or abnormal bone growth.
Some sports can repeatedly stress your bones or cause you to overstretch your lower back. Over time, this type of activity can cause additional deterioration or even fractures. This may eventually result in the bones of the spine becoming weak and shifting out of place
The following sports are especially likely to cause this condition:
- rugby
- gymnastics
- track and field
- weightlifting
The word spondylolisthesis comes from the Greek words spondylos, which means “spine” and listhesis, which means “slipping or movement.”
Surgical treatment includes a combination of decompression, fusion (with or without instrumentation), or interbody fusion. As such, patients with instability are more likely to require surgery.
Types of Spondylolisthesis
Congenital spondylolisthesis
occurs when a baby’s spine does not form the way it should before birth. The resulting misalignment can result in a higher risk for slippage later in life.
Isthmic spondylolisthesis
occurs as a result of spondylolysis. The crack or fracture further weakens the bone in your spine.
Degenerative spondylolisthesis
is the most common type of Spondylolisthesis that is due to age-related wear and tear. As we age, the disks that cushion the vertebrae start to lose water. This causes the disks to thin hence more likely to slip.
Frequently Asked Questions
What are the symptoms?
Patients with spondylolisthesis can sometimes find it hard to notice their symptoms.
The following are some signs to look out for:
- Muscle tightness and stiffness
- Pain traveling down the legs
- Pain that increases with activity
- Lower back pain and tight hamstrings
- Difficulty standing or walking
What are my treatment options?
- Anti-inflammatory medication
- Steroids injections
- Bracing
How is it diagnosed?
If your doctor thinks you might have spondylolisthesis, they may conduct a series of physical exams to diagnose your condition. For example, people with spondylolisthesis may often find it challenging to raise their leg fully outward in a straight line during test exercises. They will also order X-rays to check for any vertebra that is misaligned or even for possible bone fractures.
A CT scan will be conducted if the initial X-rays are not able to provide the necessary details. The objective of these scans is to check for any misplaced bone that could be pressing on your nerves.
Targeted Procedures
Spinal Fusion
Why choose spinal fusion?
Spinal fusion is a type of spine surgery performed to promote stability at a diseased motion segment. This usually involves removal of the lamina (portion of the vertebrae that covers the spinal cord). Removing the lamina relieves pain and pressure. Subsequently, screws and rods are inserted. Bone grafts are added to the sides of the spine. The grafted bone will then fuse to the spine.
Is it suitable for me?
You may be a candidate for spinal fusion if you have signs and symptoms of spinal instability. These may include pain, weakness or numbness of the hands and feet.
MIS TLIF
The goal of this procedure is to stabilise the spine, minimising low back and leg pain. This procedure stops the motion of the affected disc level by placing screws, rods and bone graft to promote the two vertebrae to become one bone (spinal fusion).
Typically two 2-3 cm incisions are made on either side of the lumbar spine. After the incisions are made, a minimally invasive approach is made down to the vertebral body using dilating tubes. The surgeon then ensures that spinal screws are securely placed into the vertebral body of spine. Live x-ray and live nerve monitoring are used to ensure that the screws are placed accurately.
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