Spondylolisthesis is a painful condition that occurs when a vertebra slips from its normal place in the spine, most commonly sliding over the vertebra that lies right beneath it. The condition affects both children and adults, and is usually found in the lower back.
Chances are good that if you or someone close to you haven’t suffered from spondylolisthesis, you’ve never heard of it. But while it may not be one of the more commonly discussed back disorders, there are more than three million documented cases of spondylolisthesis every year.
This condition can be chronic, lasting for many years, but is easily treatable by qualified medical professionals.
“Spondy” means spine and “listhesis” means slip. Spondylolisthesis refers to one vertebrae shifting or slipping forward or backwards relative to the adjacent vertebrae. This is a sign of instability of the spine, and the condition can cause significant back or neck pain.
The most common causes of spondylolisthesis are from degenerative changes in the spine with age or from a fracture of the weakest portion of the vertebrae, the pars interarticularis. When the pars interarticularis fractures (breaks) this is referred to as spondylolysis. When the fracture of the pars leads to a slip of one vertebrae on the other, the term applied is isthmic spondylolisthesis.
Symptoms of spondylolisthesis can range from general lower back pain to muscle stiffness in the back or legs; pain, numbness, tingling, or weakness in the legs or buttocks; and tenderness around the area of displacement. In advanced cases, there may be tightening of the hamstrings, a forward-leaning posture, or a waddling gait due to atrophy of the gluteal muscles from lack of use.
Spondylolisthesis can strike both children and adults, but is more common with adolescents, but often does not become symptomatic or problematic until later in life as an adult. With younger individuals, the cause is typically a birth defect or traumatic injury. The pursuit of certain sports, such as football, gymnastics, track and field, and weightlifting can also lead to spondylolysis (pars fracture) and spondylolisthesis because of the strain it can put on your lower back.
Wear and tear and advancing age is often the culprit in adult spondylolisthesis due to the cartilage and bones wearing down from arthritis. We typically see this in individuals over 50 years old, and more commonly in women than men.
Spondylolisthesis requires a medical diagnosis or patients run the risk of continued and advancing pain and degeneration. We all love to Google our symptoms and diagnose ourselves, but because the symptoms of spondylolisthesis can masquerade as other ailments, it’s important to see a doctor and have the appropriate tests.
During your first appointment for spondylolisthesis at the DISC Spine Institute, you can expect our friendly staff to collect your new patient paperwork and any other pertinent medical information. You will have an opportunity to discuss your symptoms and any pain you’re feeling, and our trusted surgeons will study your medical history and any labs or imaging tests you have already done. Be sure to mention any previous medical conditions, which will help the staff understand your current condition and pinpoint the exact source of your pain. At this time, they will also determine if any additional tests, like an MRI or CT scan, are needed.
Once these steps have been completed, we’ll have enough information to deliver a diagnosis and develop a plan to treat your spondylolisthesis, end your pain, and get you back to living your life.
Once spondylolisthesis has been confirmed, our industry-leading doctors, Dr. Mark Valente and Dr. Andy Indresano, will provide the best strategy for moving forward. The DISC Spine Institute prides itself on making every attempt to heal your pain using a conservative, non-surgical approach. Surgery is a last resort.
If the spondylolisthesis is stable, meaning it does not shift on x-ray with flexion and extension films or is very small, pain medications, muscle relaxants, and physical therapy may be all that is necessary for adequate control of symptoms. If there is a pars fracture, a local pars block injection can help diagnose its origin.
If pain from spondylolisthesis persists, or if surgery is the most feasible option, Dr. Mark Valente and Dr. Andy Indresano will proceed with the most minimally invasive surgical treatment possible. Our surgeons are leaders in the field of minimally invasive surgeries and are among a small group of surgeons around the world who are specially trained to perform these cutting-edge procedures.
When conservative measures are no longer controlling the symptoms or the slip is large or progressing, surgical stabilization is often necessary. This can often be done through two small, sutureless incisions in the back. This is a minimally invasive fusion procedure that is done entirely through a tube; The tube spreads the muscle fibers instead of tearing or stripping them. This leads to much quicker recovery times, less chronic pain, smaller incisions, and less scar tissue.
The post-surgery period is just as important as the surgery itself when it comes to the health and wellness of the patient. The doctors and staff at the DISC Spine Institute are committed to guiding patients through the entire process, starting with the first consultation. After surgery, we provide continued recovery support with any necessary pain medications, muscle relaxants, support bracing, metabolic supplements to help with healing of bones/nerves/soft tissue, and physical therapy, where indicated. Our staff of experienced medical assistants and physician assistants assists Drs. Valente and Indresano in order to provide an enhanced level of support to guide you through the recovery phase.
Everything we do at the DISC Spine Institute is undertaken with one goal in mind: To get you back to enjoying the life you deserve, as quickly and easily as possible.