Spondylolisthesis: what is it?

A disorder known as spondylolisthesis occurs when one vertebra in your back slides forward over the bone beneath it. The lumbosacral region of the lower spine is where it most frequently happens. Squeezing your spinal cord or nerve roots could result from this in some situations. One or both legs may become numb or weak as a result, along with back pain. Rarely, it may also result in a loss of bladder or bowel control. If you start to lose control over your bowels or bladder, you should see a doctor immediately. You might not have any symptoms at all or not experience any symptoms for years after a vertebra falls out of position. Then, you can experience buttock or low back pain. Your leg muscles may feel weak or taut. You might even limp.

Spondylolisthesis: what causes it?

Your spine’s bones are joined at a number of tiny joints that maintain their alignment while enabling movement. A issue with one or more of these tiny joints that permits one bone to go out of alignment is the cause of spondylolisthesis. Any of several issues with your back’s tiny joints might result in spondylolisthesis. You might have:

A congenital joint is one that has been flawed since birth.
a joint harmed by trauma or an accident.
a vertebra having a stress fracture brought on by excessive joint use.
a joint harmed by arthritis or an infection.

Children and teenagers who participate in sports are affected by spondylolisthesis. Weightlifting and gymnastics are two examples of sports that can overwork the back bones to the point that stress fractures in the vertebrae occur, leading to spondylolisthesis.

Spondylolisthesis can develop in older persons due to stress fractures caused by back wear and strain. When the disc and joints deteriorate and move out of alignment, it can also happen without stress fractures.

Which symptoms are present?

Spondylolisthesis symptoms can include:

buttock or back ache.
pain that radiates down one or both legs from the lower back.
One or both legs may feel weak or numb.
walking difficulties
Pain in the legs, back, or buttocks that worsens with twisting or bending.
loss of control over the bowels or bladder, in rare instances.

Spondylolisthesis can occasionally have no symptoms at all.

What choices are there for treatment?

Treatment Without Surgery

Similar to non-surgical treatment for people with low back pain and/or leg discomfort from various disorders, non-surgical treatment for adults with isthmic spondylolisthesis may involve one or more of the following:

1) Drugs To lessen inflammation in the area, use painkillers like acetaminophen, NSAIDs (including ibuprofen and COX-2 inhibitors), or oral steroids

2) Applying heat and/or cold to relieve pain in specific areas.Ice is typically advised to ease pain or discomfort right after an activity that has caused it. Applying heat is advised to ease muscle tension, encourage blood flow, and create a healing atmosphere.

3) Physical Treatment It is advised to stretch, starting with hamstring stretches and working your way up. Additionally, to reduce low back stress, extra care should be taken to stretch the hamstrings twice a day. The workout regimen should be regulated and increased progressively over time. By mobilizing painful joint dysfunction, manual manipulation by osteopathic physicians, physiatrists, or other suitably qualified medical experts can help alleviate pain.

4) Injections of epidural steroids Injections may be helpful if the patient is experiencing excruciating pain. Injections of epidurals can aid in reducing localized inflammation. For a diagnostic investigation, lidocaine and steroids can be administered into the pars fracture itself. It can be presumed that the pars fracture is the cause of the patient’s pain if it subsides following a lidocaine injection. By reducing inflammation in the pars interarticularis, the steroid may assist alleviate pain and enable the patient to continue with non-surgical treatment and physical therapy.

5) Spondylolisthesis Procedure Most of the time, patients can get their pain under control without surgery, but if not, surgery can be an option.

Surgical Intervention

Although spinal fusion surgery for spondylolisthesis is normally highly successful, it is typically not considered until a patient has tried a variety of non-surgical treatments for at least six months without experiencing any pain relief. This is because the procedure is extensive and requires a lot of recovery time. The gold standard for lumbar spinal fusion is often a posterior fusion with pedicle screw instrumentation. Simultaneously, the surgeon can suggest a spinal fusion performed from the front of the spine. The kind of spinal fusion that a surgeon recommends is mostly determined by the patient’s clinical circumstances as well as the surgeon’s preference and experience.