Spondylolisthesis is when a vertebra in the spine slips out of place, either forward or back. The nerves become pinched causing pain. It is most common in the lumbar spine but can occur in the thoracic and cervical spine as well. This can also be caused if there is a defect or a fracture of the wing bone section of the vertebra. It is often seen in children and adolescents that participate in athletic such as gymnastics. The condition can last several years or continue through a lifetime.
Causes include:
- birth defect
- fracture or other trauma
- infection
- degeneration
- older age
Symptoms include:
- lower back pain especially after exercise
- increased swayback (lordosis)
- hamstring stiffness
- muscle stiffness and tightness
- pain in the buttocks
- pain that radiates down the legs
- pain or weakness in one or both legs
- reduced ability to control bowel and bladder
- in advanced stage can affect the way a person stands and/or walks
The spine is a series of 33 bones called vertebrae. A single bone is called a vertebra. The spine is the support structure that keeps the body upright. There are 7 cervical, 12 thoracics, 5 lumbar, 5 fused vertebrae make up the sacrum and 4 fused bone make up the coccyx (tailbone).
In addition the spine also:
- provides a frame for muscles and ligaments to attach
- permits flexible movement and twisting
- protects the spinal cord and nerves
Treatments are aimed at strengthening the lower back and physical therapy is part of the treatment. If pain continues after physical therapy, surgery fusion may be necessary. Surgical fusion connects two vertebrae making the area stronger as a result. Diagnosis requires lab testing and x-ray or MRI. Other interventions may include:
- a spinal brace to limit movement and twisting
- pain medication
Goals of treatment are:
- relieve pain
- restore flexibility
- improve range of motion
- stop further slipping
Possible complications from surgery include:
- long-term back pain-management
- infection
- temporary or permanent damage to nerve roots
The condition is most common in males due to their physical activities. Children, under the age of 5 may be predisposed to the disorder and could have undiagnosed spondylolisthesis. It is also common in 7-10-year-olds due to their changing physical activities and wears and tear. Teens and young adults are also susceptible for similar reasons. Degenerative spondylolisthesis is common in adults age 50 or older.
There are different types of spondylolisthesis. These include:
- Developmental – may exist at birth or in childhood
- Acquired – from repeated force on the spine such as lifting heavy objects or falling from a ladder