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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.
Spondylolisthesis
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 a book titled Save Your Aching Back and
Neck, A Patient's Guide (Second Edition, May 2002, completely revised).
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