Spondylolisthesis occurs when one vertebral disc shifts from its proper position and slips forward over the disc below it. The spine condition can be further described by type:
Isthmic Spondylolisthesis — the narrow bridge (or isthmus) between two facet joints of a vertebra is called pars interarticularis. A stress fracture of the pars interarticularis, a condition called spondylolysis, can lead to disc slippage or isthmic spondylolisthesis. These small fractures often occur during childhood and are one of the leading causes of lower back pain in adolescents.
Degenerative Spondylolisthesis — the aging process along with chronic degenerative disc disease can encourage the muscles, bones and facet joints to slowly wear over time. Worn-down facet joints become weak and may not properly support the discs, allowing vertebrae to slip over the one below it.
Traumatic Spondylolisthesis — the most severe form of spondylolisthesis occurs when the neural arch (consisting of the laminae, pedicles and foramen) has a fracture.
Dysplastic Spondylolisthesis — a congenital defect in the neural arch can produce a displacement of vertebrae over time.
Pathologic Spondylolisthesis — certain bone diseases can weaken the spine bones and create the forward displacement of a disc.
Causes and Symptoms of Spondylolisthesis
Spondylolisthesis causes correlate to the type of spondylolisthesis:
Isthmic Spondylolisthesis is often due to repeated microfractures that can occur from continual heavy lifting or certain sports.
Degenerative Spondylolisthesis often occurs from chronic degenerative disc diseases such as arthritis, and results in weakness in part of the neural arch at the posterior of the vertebral body.
Traumatic Spondylolisthesis, as the name indicates, stems from a traumatic injury to the spine or from a post-surgery complication.
Dysplastic Spondylolisthesis originates from abnormal cell growth before birth.
Pathologic Spondylolisthesis is caused by a bone disease such as osteoporosis, a tumor or cancer.
Spondylolisthesis can be asymptomatic (without symptoms), but if it does present symptoms they are usually related to the area of the displaced vertebrae:
Lumbar spondylolisthesis is located in the lower lumbar region of the back and affects the lower back and legs:
lower back pain
tingling, numbness or leg pain such as sciatic pain or radiculopathy (pain along the nerve pathway) if the disc impinges on the nerve,
tightness in the back and thighs
muscle spasms in the hamstrings
weakness in the legs and feet
pain may be diminished when sitting
Cervical spondylolisthesis occurs in the neck and affects the neck, upper back and arms:
pain or stiffness in the neck or upper back
discomfort moving head up and down
Cervical spondylolisthesis occurs much less frequently than lumbar spondylolisthesis.
How Is Diagnosis of Spondylolisthesis Performed?
As with most medical conditions, a comprehensive review of your medical history along with a physical exam and medical imaging can help your doctor provide an expert spondylolisthesis diagnosis. Medical imaging such as x-rays, MRI (magnetic resonance imaging) and a CT scan (computed tomography) gives your physician the tools needed for proper analysis of your back or spine condition.
What Are Non-Surgical Treatments for Spondylolisthesis?
Before surgery is considered, more conservative spondylolisthesis treatments are usually recommended such as:
anti-inflammatory medication and analgesics (pain medications), and
braces or other back support.
Spondylolisthesis surgery focuses on relieving the pressure from the disc with a disc decompression, often in conjunction with a spinal fusion.
Advanced Surgical Treatments for Spondylolisthesis at NSPC
Neurological Surgery, P.C. (NSPC) provides leading-edge spondylolisthesis treatments. Our award-winning physicians and neurosurgeons offer outstanding care with revolutionary surgical techniques for the best results. Treatment centers are conveniently located in Long Island, New York.
Minimally invasive surgery for lumbar spondylolisthesis reduces both your hospital time and your recovery time. Our neurosurgeons use microscopes to make smaller incisions, creating less damage to the surrounding muscles and tissues with limited blood loss, compared to traditional open surgery.
Spondylolisthesis surgery often is a type of decompression surgery to treat the accompanying condition:
At NSPC, we perform lumbar ALIF, PLIF and TLIF for degenerative disc diseases such as lumbar spondylolisthesis that cause back or leg pain:
ALIF Anterior Lumbar Interbody Fusion treats disc compression by accessing the lumbar spine via the front (anterior).
PLIF Posterior Lumbar Interbody Fusion removes the pressure on the nerve and stabilizes the spine with a bone graft via a small incision in the posterior (back) of the spine.
TLIF Transforaminal Lumbar Interbody Fusion is minimally invasive surgery that accesses the spine via the foramen (bony arch that the spinal nerves travel).
The much rarer cervical spondylolisthesis can also be treated with surgery if conservative treatments have failed to provide relief:
NSPC has offices in Great Neck, Rockville Centre, Lake Success, Bethpage, Commack, West Islip, Port Jefferson Station, Patchogue and New York City to provide top-notch solutions to spondylolisthesis and other complex spine conditions.