What Is a Spondylolisthesis?
The word “spondylolisthesis” derives from “spondylo,” meaning spine, and “listhesis,” meaning slippage. A spondylolisthesis is a forward slippage of one vertebra (one of the 33 spinal-column bones) relative to another. A spondylolisthesis usually occurs towards the base of the lumbar spine. Spondylolisthesis can be described according to the extent of slippage. Commonly, the slippage grading system identifies Grade 1 as the least advanced and Grade 5 as the most advanced. The spondylolisthesis is graded by measuring how much of a vertebral body has slipped forward over the body beneath it.
Approximately 3-5 percent of the population has a spondylolisthesis. It becomes apparent more often in people who are involved with very physical activities such as weightlifting, gymnastics, or football. Males are more likely than females to develop symptoms from the disorder, primarily due to their engaging in strenuous activities. Although some children under the age of five may be predisposed towards having a spondylolisthesis or may already have an undetected spondylolisthesis, it is rare that such young children are diagnosed with a spondylolisthesis. Spondylolisthesis becomes more common among 7-10 year olds. The increased physical activities of adolescence and adulthood, along with the wear-and-tear of daily life, result in spondylolisthesis being most common among adolescents and adults.
Types of Spondylolisthesis.
There are several types of spondylolisthesis, commonly categorized as developmental or acquired. “Developmental” indicates that the condition may have existed at birth or may have developed during early childhood. “Acquired” means that the condition is due to trauma (like falling off a horse or ladder) or due to degeneration from the joints wearing out due to repetitive forces.
What Symptoms Might I Notice?
Many people with a spondylolisthesis have no symptoms and will only become aware of it when revealed on an x-ray for a different problem. However, there are several symptoms that often accompany spondylolisthesis:
- Pain in the low back, especially after exercise.
- Increased lordosis (i.e., swayback).
- Pain and/or weakness in one or both thighs or legs.
- Reduced ability to control bowel and bladder functions.
- Tight hamstring musculature and hip pain.
- In advanced spondylolisthesis cases, changes may occur in the way people stand and walk; for example, development of a waddling style of walking. This causes the abdomen to protrude further, due to the low back curving forward more. The torso (chest, etc.) may seem shorter; muscle spasms in the low back may occur.
How Is a Spondylolisthesis Treated?
The slippage grade and the symptoms will help determine a suitable spondylolisthesis treatment. Treatment focuses on decreasing symptoms, healing damaged tissues, and restoring the stabilizing musculature for long-term relief. The further the vertebra has slipped, the more difficult it is to find a treatment that will offer relief. There is no perfect fix for the spondylolisthesis. Treatment is focused on symptoms management rather than finding a cure, much like diabetes care. When a spondylolisthesis fails to respond to conservative care, surgery may be necessary or beneficial.
Our office has developed a successful treatment protocol to manage many grades of spondylolisthesis without the use of drugs or surgery. If you or someone you know is suffering from back pain and have not found the relief for which you are looking, please contact our office. We may be able to help you.
Information provided by Christopher M. Renze, D.C., D.I.B.C.N., of Renze Chiropractic Clinic, P.C.