Spondylolisthesis: Symptoms, Treatment, & Surgery

What is Spondylolisthesis

Spondylolisthesis is the displacement or dislocation of a vertebra. It most commonly occurs in the lower back, but it can affect any region of the spinal column. In most cases, the affected vertebra protrudes forward over the vertebra directly beneath it, impinging or compressing the nerves in the back.

Spondylolisthesis Symptoms

Common symptoms of spondylolisthesis include a sudden pain that radiates down the back or buttocks and becomes more severe when bending or twisting, a sense of weakness in the legs, and an inability to walk without significant pain. In particularly extreme cases, it can also lead to incontinence.

Spondylolisthesis Grading

Spondylolisthesis can be categorized by the extent of the displacement in relation to the length of the vertebra. If 30% of a vertebra hangs over the vertebra beneath it, for example, the displacement is a grade 2 case of spondylolisthesis.

 

Grade 1 Spondylolisthesis

In Grade 1 spondylolisthesis, 0% to 25% of the vertebra hangs over the vertebra beneath it.

Grade 2 Spondylolisthesis

In Grade 1 spondylolisthesis, 25% to 50% of the vertebra hangs over the vertebra beneath it.

Grade 3 Spondylolisthesis

In Grade 1 spondylolisthesis, 50% to 75% of the vertebra hangs over the vertebra beneath it.

Grade 4 Spondylolisthesis

In Grade 1 spondylolisthesis, 75% to 100% of the vertebra hangs over the vertebra beneath it.

Grade 5 Spondylolisthesis

In Grade 1 spondylolisthesis, the entire vertebra hangs over the vertebra beneath it.

Spondylolisthesis Treatment

Treatments for spondylolisthesis depend on the severity of the condition, but most cases respond well to more conservative measures. Indeed, surgery is generally necessary only if the displacement has significantly limited the patient’s ability to function.

Conservative

The first line of treatment for spondylolisthesis is to simply refrain from any activity that might have caused the displacement or could exacerbate it. Minor to moderate pain can be effectively relieved with ibuprofen or acetaminophen. Corticosteroid injections can also alleviate pain and swelling. These treatments should be complemented with a physical therapy program, specifically flexion exercises, which are designed to rebuild the muscles in the core and back while restoring function to the affected vertebra.

Spondylolisthesis Surgery

Should the condition result in damage to the nerves or surrounding vertebrae, spondylolisthesis can also be treated with surgery. During this procedure, your surgeon will remove any bone or tissue that might be compressing the nerves and fuse the vertebrae together to prevent further displacement. This surgery can be performed openly or arthroscopically, and complete recovery can be expected after several months of rest and physical therapy.

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