Common Spondylolithesis Questions
What is spondylolisthesis?
A spondylolisthesis is a forward slip of one vertebra over the one beneath it. Spondylolisthesis occurs most often in the lumbar (low back) spine. There are several types of spondylolisthesis, such as congenital, developmental, and acquired.
- Congenital spondylolisthesis means it is present at birth.
- Developmental spondylolisthesis may develop during childhood, but it is usually not noticed until later in life (adulthood).
- Acquired spondylolisthesis is caused by stresses exerted on the spine such as during weight lifting, gymnastics, carrying heavy items, or trauma. Degeneration of spinal anatomy may cause ligaments to weaken, allowing a vertebra to slip forward.
What causes spondylolisthesis?
Some people are born with a thin vertebral bone called the pars articularis, which, from the side resembles a Scotty dog. Force or stress, such as during a growth spurt or from trauma, may contribute to this bone breaking, causing the vertebra to slip forward. Overuse is another cause. Sports such as gymnastics and football stress the lower back.
How is spondylolisthesis treated?
Nonsurgical treatment may include activity restriction, medication to reduce inflammation and pain, a brace to temporarily support the spine, spinal injections, and physical therapy.
Will I need surgery to fix my spondylolisthesis?
That depends on many issues, including the severity of the spondylolisthesis, if serious neurological symptoms exist (bowel/bladder dysfunction), and the success (or failure) of nonsurgical care.
Surgery aims to remove pressure on spinal nerves (called decompression) and stabilize the spine. Usually, low back decompression is combined with spinal fusion and instrumentation. Fusion involves placing bone graft around spinal instrumentation (cages, rods, screws, plates) to stimulate bone to grow together into a solid construct. Spine surgery can be performed from the back or front of the spine.
Your surgeon may prescribe a bone growth stimulator to help your spine fuse after surgery. A bone growth stimulator is a light-weight device you wear over your clothing and brace (if bracing is necessary).
Is a brace necessary after surgery?
Many patients need to wear a brace after low back surgery. The brace is worn for 3 to 6 months. It is important to wear the brace as instructed because the brace helps to support your spine while it heals. An x-ray is performed at regular intervals to make sure your spine is fusing.