Spondylolisthesis occurs when one of the vertebrae in the spine slips out of place onto the vertebra below it. This condition can cause pain and can lead to spinal instability if left untreated.

Types of Spondylolisthesis

• Congenital Spondylolisthesis: Present at birth due to abnormal bone formation.
• Isthmic Spondylolisthesis: Caused by a defect or fracture in a part of the vertebra.
• Degenerative Spondylolisthesis: Due to age-related changes in the spine, such as arthritis.
• Traumatic Spondylolisthesis: Resulting from an injury or trauma to the spine.
• Pathological Spondylolisthesis: Caused by a disease, such as osteoporosis or cancer.
• Post-Surgical Spondylolisthesis: Resulting from spinal surgery.

Symptoms

• Lower Back Pain: The most common symptom, which may worsen with activity.
• Leg Pain: Pain that radiates down the legs, similar to sciatica.
• Tight Hamstrings: Hamstring muscle tightness can be a sign of spondylolisthesis.
• Numbness or Tingling: In the legs or buttocks.
• Weakness: In the legs, making it difficult to walk or stand for long periods.
• Postural Changes: A forward-leaning posture or a noticeable bump in the lower back.

Causes

• Genetics: A family history of spondylolisthesis.
• Overuse: Repetitive stress on the spine, common in athletes.
• Injury: Trauma to the spine.
• Degenerative Changes: Age-related wear and tear on the spine.

Diagnosis

Diagnosis typically involves:

• Medical History and Physical Exam: Evaluating symptoms and examining the spine.
• Imaging Tests: X-rays, MRI, or CT scans to visualize vertebra slippage and assess the degree of displacement.
• Nerve Function Tests: Electromyography (EMG) and nerve conduction studies if nerve damage is suspected.

Treatment

Treatment aims to relieve pain, stabilize the spine, and improve function.

Non-Surgical Treatments

• Rest and Activity Modification: Avoid activities that exacerbate pain.
• Medications:
  • Pain relievers (NSAIDs, acetaminophen).
  • Muscle relaxants.
  • Corticosteroid injections to reduce inflammation.
• Physical Therapy: Exercises to strengthen the back and abdominal muscles, improve flexibility, and reduce pain.
• Bracing: A brace can help support the spine and reduce pain.
• Hot and Cold Therapy: Applying heat or ice packs to reduce pain and inflammation.
• Alternative Therapies:
  • Chiropractic care.
  • Acupuncture.
  • Massage therapy.

Surgical Treatments

Surgery may be considered if conservative treatments fail and symptoms are severe:

• Spinal Fusion: Fusing two or more vertebrae to stabilize the spine and prevent further slippage.
• Laminectomy: Removing part of the vertebra to relieve pressure on the nerves.
• Foraminotomy: Enlarging the space where the nerve roots exit the spine to relieve pressure.