What is Spondylolisthesis?
Spondylolisthesis occurs when one vertebra slips forward on the adjacent vertebrae. The condition may be congenital, or the result of physical stresses on the spine or spinal degeneration. It may produce both a gradual deformity of the lower spine and also a narrowing of the vertebral canal, and can cause back pain, leg pain and other symptoms.
A spondylolisthesis is graded according to the amount that one vertebral body has slipped forward on another. A grade I slip means that the upper vertebra has slipped forward less than 25 percent of the total width of the vertebral body, a grade II slip is between 25 and 50 percent, a grade III slip between 50 and 75 percent, a grade IV slip is more than 75 percent, and in the case of a grade V slip, the upper vertebral body has slid all the way forward off the front of the lower vertebral body, a condition called spondyloptosis.
What Are The Symptoms Of Spondylolysthesis?
The most common symptom of spondylolisthesis is low back pain. Usually the pain is relieved by extension of the spine and made worse when flexed. The degree of vertebral slippage does not directly correlate with the amount of pain a patient will experience. Fifty percent of patients with spondylolisthesis associate an injury with the onset of their symptoms. In addition to back pain, patients may complain of leg pain. In this instance, there can be associated narrowing of the area where the nerves leave the spinal canal that produces irritation of a nerve root.
How is spondylolisthesis treated?
Spine surgery is typically considered only after conservative therapies fail to adequately relieve symptoms over a significant period of time, or if evidence of nerve involvement, such as numbness or tingling, muscle weakness or bowel or bladder impairment, develops. The overall goal of surgery is to stop the slippage, remove the source of irritation and inflammation and restore the stability of the spine.