Spondylolisthesis: A Vertebra that Slips
Have you ever heard of the Greek language? Many of the words in medicine come from Greek words. Spondylolisthesis is one such word. If we divide this big word into two parts we can learn what it means - Spondylo / olisthesis.
In Greek, "spondylo" means vertebra (ver-tea-bra) and "olisthesis" means to slip. So when we put the two parts back together it makes the meaning of Spondylolisthesis easier to understand - a vertebra that slips!
Young and Old
Sometimes babies are born with spondylolisthesis. This is called Congenital Spondylolisthesis. Doctors use the word congenital (con-gen-it-all) to mean the patient was born with the disorder.
Children under age six rarely develop spondylolisthesis, although during growth spurts the chances increase. This disorder can affect adults too. As people age, wear and tear from daily stress to the spine can weaken the bones, muscles, and ligaments. Carrying heavy things, playing football, performing gymnastics, weightlifting, and injury also stress the spine.
The lumbar vertebrae (lum-bar ver-tea-bray) in the low back are the largest bones in the spine. These bones support most of the body's weight. That is why spondylolisthesis often occurs in the low back.
Wherever a vertebra slips it can cause pain. When spondylolisthesis affects the low back the symptoms may include back, thigh, and leg pain, along with weakness. Some people look shorter and swayback. Their stomach may stick out and they waddle when walking. Amazingly, there are people who have no idea they have spondylolisthesis until it is found on an x-ray!
An x-ray of the patient's side is taken while standing. The x-ray will show where the vertebra has slipped over the vertebra below. The doctor uses a grading system to measure how far the vertebra has slipped over the one beneath.
Spondylolisthesis on an X-Ray (see arrow)
Treatment Without Surgery
If the spondylolisthesis is stable - meaning the vertebra has stopped slipping - no treatment is needed. The patient just continues to visit the doctor to see if the spondylolisthesis changes.
When treatment is needed, it might include the following:
Bed rest for two or three days.
Stop or limit activities that stress the spine; such as heavy lifting and sports.
Medication to control pain and swelling (inflammation).
A special brace.
Sometimes the doctor will order a special brace to be made for the patient. A person who makes braces is called an Orthotist (or-tha-tist). An Orthotist is trained to know all about braces and how to take exact body measurements. A cast might be made to create a sample of the patient's body. Then, the Orthotist has a model of the patient's body to design a brace that fits correctly.
"Do I Have To Have Surgery?"
This is a common question because most people do not want surgery. In fact, the doctor does not want his or her patient to have surgery unless it is really needed. Some patients with a spinal disorder develop nerve problems or pain that will not go away. Sometimes surgery is the best treatment.