Spondylolisthesis is an anterior displacement or shift forward of a vertebra in relation to the vertebra below it. It can affect any vertebra but generally affects the fifth lumbar vertebra. Spondylolisis is a defect in the pars, interarticlularis, facets or neural arch generally caused by a stress fracture. These structures hold the spinal column in alignment and damage to them may weaken the spine allowing slippage and causing compression of nerves.
These conditions are caused by overuse such as you would see with athletes who perform sports such as weight lifting, gymnastics and football. Repeated hyperextension causes stress fractures that may be non-symptomatic but weaken the spine. These stress fractures may weaken the vertebra enough to allow shifting and subsequent pressure on the nerves. A hereditary aspect may also be present with some people being born with thinner vertebra more susceptible to injury. Studies done conclude that of the people who have spondylosis and spondylisothesis many have no pain at all. Spondylolisthesis is graded by the degree of anterior slippage on a scale of one to five with five being the greatest amount of slippage. There are five types of spondylolisithesis, dysplastic, isthmus, degenerative, pathological and traumatic. Dysplastic spondylolisthesis is congenital and can cause severe neurological deficits. Isthmic spondylolisthesis is the most common form of the disorder. Degenerative spondylolisthesis occurs in older adults as a result of arthritic and degenerative changes. Pathological spondylolisthesis occurs from tumors and Paget’s disease and is very rare, as is traumatic spondylolisthesis which occurs from injury.
Spondylolisthesis and spondylolisis may be asymptomatic; however, if there are symptoms they include back pain, spasms, stiffness and possible numbness and tingling if nerves are compressed.
Spondylolisis and spondylolisthesis can be diagnosed by x-ray, CT scan or MRI. Your doctor may want repeated X-rays every so often to track any new developments as the condition can progress.
Treatment of spondylolisis and spondylolisthesis involve rest from the aggravating activities, anti-inflammatory such as Ibuprophen and Naproxen and possibly narcotics. Your doctor may recommend physical therapy to strength back and abdominal muscles. Back brace s are occasionally recommended. Surgery is rarely needed unless the spine shifts to the degree it causes symptoms that interfere with the activities of daily living. If surgery is done a spinal fusion is the usual procedure.
Spondylolisthesis and spondylolisis occur in approximately seven percent of the general population and often asymptomatic and easily treated with medication and medical modalities.
Sources:
<http://en.wikipedia.org/wiki/Spondylolisthesis>
<http://www.chirogeek.com/005_Spondylolisthesis_main_final.htm>
<http://orthoinfo.aaos.org/topic.cfm?topic=A00053>
This article is informational only and is not medical advice. Always follow up with your doctor for questions about your health.
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Spondylolisthesis and Spondylolisis: The hidden cause of back pain