Spondylolisthesis

What is spondylolisthesis?

Spondylolisthesis is a spinal condition where one of the bones (vertebrae) in your spine slides out of place onto the vertebra below it. It is not the same as a slipped disc which happens when the cushioning between your vertebrae bulges out. Spondylolisthesis often causes pain, and can happen anywhere along the spine but is most common in the lower back. It can usually be treated without needing surgery. 

What are the symptoms of spondylolisthesis?

You may not experience any symptoms of spondylolisthesis. Some people have the condition but aren’t aware of it. The main symptoms of spondylolisthesis include:

• pain and stiffness in your lower back
• difficulty standing or walking for long periods 
• pain that extends to your buttocks or thighs
• tight hamstrings (the muscles in the back of your thighs) or muscle spasms
• pain, numbness or tingling spreading from your lower back down your leg into your foot (sciatica)

What causes spondylolisthesis?

• Some people are born with a thinner vertebral bone which makes it more likely for them to get spondylolisthesis.
• In older adults, wear and tear on the spine and discs (cushions between vertebrae) can weaken the structures supporting your spine, and cause a bone to slip.
• Spinal fractures can also weaken the vertebrae, causing it to slip forward.
• Growth during adolescence may also be a factor especially if you have the condition in your family.
• Playing sports and over-extending your spine can also be a contributing factor.

How is Spondylolisthesis diagnosed? 

Your doctor will discuss your symptoms with you and carry out a physical examination. They will usually examine your back, and may ask you to lie down and raise one of your legs straight up in the air. If you have tight hamstrings or sciatic caused by spondylolisthesis, this will be painful. Your doctor may also send you for additional scans or tests such as: 

• X-ray of your spine to see if one of your vertebrae is out of place.
• CT scan or MRI scan if you have pain, numbness or weakness in your legs, to see if there is damage to your soft tissues.

How is Spondylolisthesis treated?

The treatment of spondylolisthesis depends on the degree of slippage and how severe your symptoms are.

Conservative Treatments include:

• rest
• avoiding activities that make your symptoms worse, such as lifting, bending, and some sports 
• taking anti-inflammatory painkillers such as ibuprofen 
• steroid injections in your back to reduce inflammation and relieve pain, numbness and tingling 
• physiotherapy to strengthen and stretch the muscles in your lower back, tummy and legs

Surgical intervention

If these measures do not help, or if you have severe slippage, you may need surgery to stabilize your spine, relieve pressure on your nerves, and correct the alignment of your spinal column. Possible surgical procedures include

• Spinal fusion where the slipped bone (vertebra) is bonded to the bone below it with metal rods, screws and a bone graft
• Lumbar decompression, which is a procedure to relieve pressure on the compressed spinal nerves