Spondylolisthesis is a condition that occurs when one vertebra in the spinal column slides over the one below it. Damage to the bone or joints in a vertebra can cause this slippage. When the vertebra moves out of position, the spinal cord or nerve roots may be pinched causing symptoms of pain and other neurological dysfunction. Spondylolisthesis can also lead to deformities of the spine such as lordosis or kyphosis.
Although spondylolisthesis can occur anywhere in the spine, it is most often seen in the lower back. It can be the result of joint or bone problems in the spine due to degenerative changes over time, trauma, birth defects, or tumors. In adults, the degenerative changes to the spine associated with age are most commonly responsible for the development of spondylolisthesis. For children, the condition is mostly due to a defect in the vertebrae present at birth, or can arise after sustaining a sudden injury to the spine. Athletes who are involved in sports such as weight lifting, gymnastics, and football endure a great deal of stress to their lower backs. They are at a greater risk for stress fractures in the vertebrae (spondylolysis) and the possibility of developing spondylolisthesis.
Symptoms of spondylolisthesis may be mild to severe with some individuals not experiencing any symptoms. For those with spondylolisthesis in the lower back symptoms can include:
- Lower back pain
- Muscle spasms or tightness of the hamstrings
- Stiffness of the lower back
- Pain, numbness, or tingling in the buttocks and thighs and weakness in the legs due to nerve compression
In severe cases the compression of the nerves from spondylolisthesis can cause difficulty walking and bowel or bladder control issues to develop.
Following a complete medical history and physical examination to evaluate the spine the doctor may order x-rays and additional diagnostic tests. These will determine if in fact spondolylolisthesis is present, as well as what other conditions might be affecting the spine.
Treatment of spondylolisthesis depends on how much the vertebra has shifted out of place and the severity of the symptoms. Many individuals with spondylolisthesis respond to conservative therapy. Their symptoms are somewhat alleviated with hot and cold therapy, pain and anti-inflammatory medications, physical therapy and exercise, and an epidural injection as necessary. In certain cases, a back brace is recommended to bring the vertebrae into alignment and to help with healing. When symptoms do not improve with conservative care, or if the symptoms are severe, surgery may be recommended.