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Spinal conditions, specifically Spondylolisthesis 1can cause lower back pain, sometimes severe. It is caused by slipped vertebrae and relief can be provided by non-surgical treatment, but what about a long-term cure for Spondylolisthesis2?
In this article, we will talk about what Spondylolisthesis is, why it causes back pain, and the measures you can take to cure it.
What is Spondylolisthesis?
Before we start talking about potential cures and treatments it is important to establish what is spondylolisthesis? Spondylolisthesis is a spinal condition that results in vertebrae instability, usually causing back pain (and sometimes lower leg pain) due to pressure on the nerves.
The word Spondylolisthesis comes from the Greek words spondylos (spine/ vertebra) and listhesis (meaning slipping or a sliding-like movement).
Is there a difference between Spondylolisthesis and Spondylolysis?
Both Spondylolisthesis and Spondylolysis cause lower back pain, and even though they are closely related, they are not the same condition.
Spondylolysis is common amongst young athletes and sports people and is caused by a stress fracture or a crack in a bone (or bones) within the spine.
What causes Spondylolisthesis?
The main cause of Spondylolisthesis3 is the overextension of the spine. This could be the result of a sports injury, or perhaps even a genetic condition (the types of Spondylolisthesis are listed below). However, the most common cause is aging, as the discs in the back wear down over time and slip out of place.
The Types of Spondylolisthesis?
There are three common forms of Spondylolisthesis and three less common forms.
The six types of Spondylolisthesis are:
Common forms
- Degenerative Spondylolisthesis – This is the most common form of Spondylolisthesis and is a result of aging. Vertebrae are cushioned by a soft tissue known as discs, over time these discs begin to lose moisture, meaning they can slip out of position.
- Congenital Spondylolisthesis – This occurs before birth when the baby’s spine does not form properly and the vertebrae are misaligned. This increases the chance of slipped vertebrae later in the person’s life.
- Isthmic Spondylolisthesis – This type of Spondylolisthesis happens as a result of a break or fracture which weakens the vertebrae.
Less Common forms
- Traumatic Spondylolisthesis – This is the result of an injury that causes the vertebrae to slip out of place.
- Post-Surgical Spondylolisthesis – The slipped vertebrae is caused by spinal surgery.
- Pathological Spondylolisthesis – This form is caused by a disease (E.G. Osteoporosis or a tumor).
What are the symptoms of Spondylolisthesis?
Some people can have Spondylolisthesis and not encounter any symptoms, with many people not even realizing they have it. However, if a person does experience symptoms, they can include:
- Lower back pain (the main symptom of Spondylolisthesis)
- Stiffness in the back
- Pain when bending over
- Muscle spasms in the hamstrings
- Difficulty when walking and standing for long periods
- Numbness, a tingling sensation, and/ or weakness in the foot
Is Spondylolisthesis common?
Figures show that Spondylolisthesis and Spondylolysis affect between 4% to 6% of the adult population. However, many people can live with the issue without experiencing any symptoms, therefore, they do not realize they have it and have never been diagnosed. As a result, the amount of people who have Spondylolisthesis and spondylolysis is likely higher.
Degenerative Spondylolisthesis usually occurs in adults aged over 50, and it is more common among women.
Why does Spondylolisthesis cause back pain?
As Spondylolisthesis is a condition that is caused by the instability of the spine (vertebrae), it may come as no surprise that one of the main symptoms is back pain, specifically, lower back pain.
But why? When a vertebra slips out of place, it places pressure on the vertebrae below and the surrounding nerves, resulting in discomfort and sometimes significant pain. This pain can also spread to the upper parts of the leg, and there may even be some unpleasant sensation in the feet.
What to avoid if you have Spondylolisthesis
Unfortunately, Spondylolisthesis can make exercising difficult, and in some cases, many forms of exercise can make the symptoms worse. Exercises that involve heavy lifting, twisting, turning, and bending can aggravate the situation. Therefore, it is a good idea to consult with your doctor to check which sports are safe to participate in and will not worsen your back pain.
If you are suffering from Spondylolisthesis, exercises, and sports that you should usually avoid are:
- Weight training and powerlifting
- Athletics, gymnastics, and running
- Soccer
- Football
- Competitive swimming and diving
- Some dance, E.G. ballet
How can I cure my Spondylolisthesis?
There is a range of treatments a person can have to help alleviate the pain caused by Spondylolisthesis. However, if a patient no longer responds to treatment then the next step would be to consider surgery.
There are three types of surgery a person can consider to help cure Spondylolisthesis; Spinal Fusion, Spinal Decompression, or a TOPS System.
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Spinal Fusion
Spinal Fusion surgery4 involves fusing a bone graft between the slipped vertebrae to provide long-term stability. The bone graft is held in place using screws and rods and once healed, the graft, vertebrae, screws, and rods will become one.
This prevents the vertebrae from moving, avoiding any future instability.
The main downside to this is that it prevents natural movement within the spine, making some movements difficult to perform. In some cases, this surgery can also result in deterioration in the adjacent vertebrae.
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Spinal Decompression
Spinal Decompression surgery 5involves removing parts of the vertebrae that are applying pressure on the spinal cord and surrounding nerves. For Spondylolisthesis, surgeons often perform a type of spinal decompression known as a laminectomy, which removes the lamina (the small plate or layer that covers the vertebrae).
This surgery is effective at relieving pain but can cause some instability of the spinal column further down the line.
- Wiltse, Leon L., P. H. Newman, and I. A. N. Macnab. “Classification of spondyloisis and spondylolisthesis.” Clinical Orthopaedics and Related Research® 117 (1976): 23-29. ↩︎
- van Rens, Th JG, and J. R. Van Horn. “Long-term results in lumbosacral interbody fusion for spondylolisthesis.” Acta Orthopaedica Scandinavica 53.3 (1982): 383-392. ↩︎
- Lonstein, John E. “Spondylolisthesis in children: cause, natural history, and management.” Spine 24.24 (1999): 2640. ↩︎
- Deyo, Richard A., Alf Nachemson, and Sohail K. Mirza. “Spinal-fusion surgery—the case for restraint.” The Spine Journal 4.5 (2004): S138-S142. ↩︎
- Yousefifard, Mahmoud, et al. “Early versus late spinal decompression surgery in treatment of traumatic spinal cord injuries; a systematic review and meta-analysis.” Emergency 5.1 (2017). ↩︎
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