Spondylolisthesis (spon-de-low-lis-thee-sis) means one vertebra slips over the one below. This disease primarily affects the elderly as a degenerative disease but, it can be congenital (present at birth) or discovered early in life. Childhood spondylolisthesis may result if the pars articularis (parz are-tick-you-lar-es) does not fuse during early development. Posterior vertebral weakness results when these bony elements do not grow together. Spondylolisthesis may occur following injury or overuse because the bony weakness makes the area weak and susceptible to break. A spine expert is best qualified to treat this condition.
Elderly or degenerative spondylolisthesis develops when the stabilizing spinal structures begin to deteriorate. This usually occurs in the lower back, which carries most of the body's weight. Sometimes the spinal joints become arthritic and wear out, which may cause spinal instability. As vertebrae (ver-ta-bray) lose normal alignment one vertebra may slip forward over the vertebra below it. When this happens the neural foramina (space where nerves leave the spinal canal) may become closed causing nerve compression and sciatica. This condition is similar to spinal stenosis.
In most cases, spondylolisthesis is treated non-surgically. Treatment may include a course of physical therapy, steroid-anesthetic injections, and medication (prescription or over-the-counter) for inflammation and pain. When nonsurgical treatment fails, and depending on the patient's symptoms, a surgical procedure may be considered. In cases of severe slippage or instability, a spinal fusion may be necessary. Spinal fusion helps to stabilize the weak area of the spine using rods, screws, or plates, and bone graft. Leg pain, weakness, or numbness may be alleviated by a surgical procedure called a foraminotomy (for-am-not-toe-me). This procedure increases the size of the neuroforamen and cleans away debris that clogs the neural foramina.
This article is an excerpt from the book Save Your Aching Back and Neck: A Patient’s Guide, edited by Dr. Stewart Eidelson.