Treatment for Spondylolisthesis

Spondylolisthesis occurs when adjoining vertebrae slide in relation to each other resulting in an abnormal positioning. Of course, this can put pressure on the spinal column and/or associated nerves and produce sciatica.

Isthmic spondylolisthesis symptoms
Cases of spondylolisthesis are graded according to the degree of vertebral slippage from grade 1 (less than 25 percent slippage) through to grade 5 (100 percent slippage - where the top vertebra completely falls off the vertebrae below it.) Some individuals with lower grade cases may not have symptoms. Estimates are that 80% of people with spondylolisthesis will never have symptoms.

Symptoms depend on the amount of contact with the nerves. They may include:

1. local pain or radiating pain
2. pain in the leg or buttock
3. generalized numbness
4. tingling or weakness
5. inability to control urine or stool, or to begin urination (This may indicate that the slippage is pushing on the spinal cord and is considered an emergency.)
6. long term back pain and or sciatica.

Possible causes of spondylolisthesis are:

1. degenerative (arthritis)
2. congenital (birth defect)
3. isthmic, (having a spondyloltic defect)
4. traumatic (stress fractures etc often caused by repetitive hyper-extension of the back eg: gymnasts)
5. pathologic (bone disease)

In the most common cause (degenerative), the slip usually occurs between the fourth and fifth lumbar vertebrae where there is the most curvature of the spine.

One underlying factor in spondylolisthesis involves muscle balance. Especially if there is a core muscle imbalance, pelvic dysfunctions may occur. The muscles put abnormal pressure on the spine affecting stabilization (bones do not move on their own), especially of the lower spine. Any treatment needs to consider this factor (follow the link above) which, in many cases, may be the root cause of the problem. If it is not addressed other treatments will have less success than they might.

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Treatment for spondylolisthesis
Treatments commonly include cortisone injections into the joint, non-steroidal anti-inflammatory drugs (NSAIDs such as Ibuprofen), heat treatments, ultrasound, electrical stimulation, and therapeutic exercises.

In more serious situations, surgery can correct the contact between vertebra and nerve and stabilize the vertebrae to prevent further nerve impingement.

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