An Overview of Spondylolisthesis

The pain was both sudden and excruciating. It first stabbed me when I started to bend over to fill a bowl of cat food. I could hardly straighten my body. The frightening sensation started in my lower back and traveled like a bolt of lightning toward my right hip. Sitting down was agony until I shifted my position. I assumed the problem was a muscle strain. However, X-rays showed it was due a condition known as spondylolisthesis.

According to the Cleveland Clinic, another name for spondylolisthesis is cervical spondylosis. The condition occurs when a vertebra slips out of place and onto the one below it. After a certain amount of slippage, the vertebra might press on a nerve, causing pain in the spine. This most commonly occurs in an individual's lower back.

Causes and Risk Factors

There are various forms of spondylolisthesis. They're differentiated according to their causes, which include congenital malformation, injuries or fractures, degeneration of the spine, disease and surgery. The disorder is the most frequent cause of back pain that teenagers report and often makes itself known during a teenage growth spurt. The degenerative type typically occurs after age 40.

MedlinePlus reports that the most frequent cause of this condition in adults is a degenerative disease like arthritis. The most common site of slippage is between the patient's fourth and fifth lumbar vertebrae. Some types of physical activity - gymnastics, weight lifting and football among them - can cause stress fractures that force the vertebrae to shift out of position.

A family history of back problems also puts an individual at elevated risk for developing spondylolisthesis, MedicineNet indicates.

Symptoms

Although lower back pain is a hallmark of this disorder, some individuals don't even know they have the condition. Most patients, however, report pain that spreads across the back and that feels like a strained muscle.

Spondylolisthesis sometimes also results in spasms in the hamstring muscles located in the back of the thighs. This causes an odd gait. Other signs include pain radiating down a leg to a foot and the sensation or tingling and/or numbness.

In cases of severe compression of the spinal nerves, patients can experience loss of bowel control or bladder function.

Treatment

The most conservative treatment is rest or otherwise taking a break for any activities that aggravate the pain associated with the disorder. Doctors sometimes recommend non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen to help cut pain and inflammation. Some patients get relief from epidural injections of steroids.

Assistive devices like braces and back supports can help stabilize the spine. Many patients improve after physical therapy or a regimen of exercises lasting several months.

When these steps fail to relieve symptoms and pain consistently interferes with daily activities, doctors usually refer the patient to an orthopedic surgeon to evaluate the need for surgical intervention. The two most common surgical techniques to bring relief are decompressive laminectomy and spinal fusion.

While spondylolisthesis can't actually be prevented, the prognosis for most patients is a good one. Most respond to conservative treatment. For the severest cases, surgery is often helpful in relieving pain and other aggravating symptoms.

Sources:

http://my.clevelandclinic.org/disorders/Back_Pain/hic_Spondylolisthesis.aspx

http://www.nlm.nih.gov/medlineplus/ency/article/001260.htm

http://www.medicinenet.com/spondylolisthesis/article.htm