Spondylolisthesis, Symptoms and Treatment
In this disease where the vertebrae of the spine move out of place, timely diagnosis and medical treatment is essential to prevent nervous complications that deteriorate the patient's quality of life. I am waiting for you in my office, but first, I will explain in detail what spondylolisthesis is, what its symptoms are and how we can treat it.
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What is spondylolisthesis?
Spondylolisthesis is a condition where one of the vertebrae of the spine moves out of position above the vertebra below it. A mild slippage may not cause any symptoms; however, a greater degree of displacement can cause pressure on the nerves causing more intense symptoms to appear.
The vertebrae most affected by spondylolisthesis are those located in the lumbosacral region of the spine.
Causes of Spondylolisthesis
Spondylolisthesis can be caused by previous problems in the joints of the back, such as:
Birth defects from birth.
Joint damage from a past accident or trauma.
Fractured vertebrae due to stress (overuse of the joints of the back).
Inflammatory or infectious processes in the joints, such as arthritis.
In children and adolescents, spondylolisthesis appears due to congenital factors or excessive tension of the bone structures of the back when playing sports such as gymnastics, weightlifting or American football.
In adults, the main cause is the wear and tear of bones and cartilage generated by diseases such as arthritis. In this case, the patients are usually people over 50 years of age.
Symptoms of Spondylolisthesis
The symptoms of spondylolisthesis can range from mild to intense depending on the degree of vertebral displacement that the patient has. Symptoms may include:
Pain that spreads to the buttocks, legs, and feet.
Muscle tension.
Numbness or tingling sensation.
Rigidity.
Tenderness at the site of the affected vertebra.
Weakness in the legs caused by nerve compression.
Diagnostic process - What to do in the event of a symptom?
In consultation, the first thing we will do is to know your medical history and perform a physical examination that includes: palpation of the spine and the execution of specific movements with your legs to verify the intensity of the symptoms. X-rays can help us identify if the vertebra is only displaced or if it is fractured.
On the other hand, through an MRI or a CT scan we can check if the spinal canal has narrowed and if there is (or not) a nerve tightness.
Types of Spondylolisthesis
Spondylolisthesis is classified according to its etiology, represented as follows:
Type I (Congenital):
Caused by joint deformities.
Type II (Isthmic)
Caused by defects in the interarticular portion.
Type III (Degenerative)
It is caused by degenerative processes that affect the joints, which is frequently associated with osteoarthritis.
Type IV (Traumatic)
Derived from fractures, trauma, dislocations, etc.
Type V (Pathological)
Caused by bone abnormalities, infections, tumors, cancer, among others.
Treatment for Spondylolisthesis
Grade I and II displacements usually do not require surgical treatment. The type of treatment applicable for each patient varies depending on their state of health, age, degree of spondylolisthesis, and intensity of symptoms.
Conservative treatment for spondylolisthesis includes measures such as:
Rest.
Stop physical activities until the pain goes away.
Wearing a corset to limit spinal movements.
Nonsteroidal (oral) anti-inflammatory drugs.
Physical therapy (stabilizing exercises and routines for strengthening the structures of the back).
Surgical treatment for spondylolisthesis aims to relieve pain, reduce nerve pressure, and stabilize the displaced vertebra so that the patient’s back enjoys normal function. To do this, two types of procedures can be applied:
First we have decompressive laminectomy, through which we remove a small sheet of the affected vertebra in order to decompress the nerves. Although this operation significantly reduces pain can leave the spine unstable, for this reason, the patient must undergo a second procedure.
The next step is to perform spinal fusion surgery to increase the stability of the spine. In this case, the displaced vertebra is fused together with another, using screws or metal rods to prevent the vertebral displacement from occurring again.
Prevention of spondylolisthesis
In most cases, spondylolisthesis is not preventable; however, there are precautions that can be taken into account to minimize the risk of suffering this type of vertebral slippage, these are:
Perform daily exercises that strengthen the muscles of the back and abdomen.
Practice sports that do not pose a risk to the back, for example: swimming or cycling.
Maintain a healthy weight.
Eat a good diet that contributes to the development of strong bones.
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I invite you to schedule a medical appointment with me; In this way, I will be able to carefully evaluate your condition and offer you the best treatment or surgery alternatives to eradicate back pain and recover your general well-being.
