Spondylolisthesis Explained: Causes, Symptoms, & Treatments

• Written by Gungun Bhatia

  Reviewed by Akhil Pillai

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Imagine living each day with a persistent ache in your lower back, stiffness, and dull pain radiating down your legs. For millions of people worldwide, this is not just imagination—it's daily life due to a condition called Spondylolisthesis. Although the name sounds daunting, understanding the condition and exploring effective spondylolisthesis treatment options can lead to relief, recovery, and a renewed sense of mobility.

Whether you have recently been diagnosed or you've been dealing with ongoing issues, this guide will explain Spondylolisthesis, its causes, the symptoms to watch for, and the latest treatments available.

What is Spondylolisthesis?

Spondylolisthesis (pronounced spohn-di-low-less-thee-sis) is a spinal condition where a vertebra (one of the bones in your spine) slips out of place onto the vertebra below it. This misalignment can lead to pain, nerve compression, and, in severe cases, limited movement and function. The severity of spondylolisthesis is often measured in grades (I to V), depending on how much the vertebra has slipped. 

Spondylolisthesis can develop anywhere along the spine. However, it most frequently occurs in the lower back (lumbar spine). It can also affect the neck (cervical spine) or the mid-back, from the base of the neck to just below the ribs (thoracic spine).

How is Spondylolisthesis Graded?

The degree of slippage determines the spondylolisthesis grade. The Mayerding classification is this:

• Grade I: 1-25% slip
• Grade II: 26-50% slip
• Grade III: 51-75% slip
• Grade IV: 76-100% slip
• Grade V: Complete slippage (spondyloptosis)

Understanding the cause and extent of the slippage is key to developing an effective spondylolisthesis treatment plan. So, let's discuss the causes.

What Causes Spondylolisthesis 

Spondylolisthesis happens when one vertebra moves forward over the one below it. There are different reasons why this can occur.

• Wear and tear with age.
• Birth defects
• Another condition, such as a spinal tumour or osteoporosis
• Spinal surgery
• Having naturally thinner vertebrae than usual.
• Sports injuries.
• Growth spurts (in kids and teens).
• Direct trauma

Types of Spondylolisthesis 

Based on their cause, spondylolisthesis can be divided into several categories. To make an accurate diagnosis and choose the best course of spondylolisthesis treatment, it is essential to understand these categories. The primary kinds are as follows:

Congenital Spondylolisthesis 

Also known as Dysplastic spondylolisthesis, it is present at birth and occurs due to a defect in the formation of vertebrae. In simple words, Congenital spondylolisthesis happens when a baby's spine doesn't form the way it should before they're born.

Isthmic Spondylolisthesis 

This spondylolisthesis is caused by a stress fracture or defect, often in the vertebra's pars interarticularis, leading to slippage. It is common in athletes. The fracture weakens the vertebra and can cause it to lose its normal position.

Degenerative Spondylolisthesis

This is the most common type of spondylolisthesis in adults over 50. It usually happens because the spine changes with ageing. As the body ages, the discs that act as cushions between the vertebrae break down. When these discs get thinner, there's a greater chance for the vertebrae to slip out of place.

Traumatic Spondylolisthesis 

Traumatic spondylolisthesis happens when an injury or accident puts excessive pressure on your spine. This force can cause one of the bones in your back, called a vertebra, to slip out of its normal position.

Pathological Spondylolisthesis 

This type happens because of diseases or conditions that make bones weaker, like cancer, osteoporosis, or infections like tuberculosis. Slippage occurs because the bones are structurally weak, not due to stress or injury.

Postsurgical Spondylolisthesis 

Postsurgical Spondylolisthesis occurs after a previous spinal operation. The vertebrae may begin to slip after a spinal fusion or other corrective procedures due to insufficient stabilisation or improper healing.

Whether congenital, degenerative, or injury-induced, each type requires distinct considerations for spondylolisthesis treatments. Therefore, understanding the origins of each type is crucial, which we will now explore. 

Recognising the Symptoms

Spondylolisthesis symptoms can vary a lot. Some people may feel nothing, while others may have severe pain. The signs can look a lot like other back problems. Here are some common ones:

• Stiffness in the lower back
• Numbness in the legs
• Loss of bladder or bowel control
• Persistent lower back pain
• Pain that travels to the legs or buttocks
• Tightness or spasms in the muscles

If you're experiencing any of these symptoms, it is essential to consult a doctor. Early diagnosis can help with appropriate spondylolisthesis treatment and lower the chance of future complications. Let's explore treatment options in detail.

Diagnosis of Spondylolisthesis

To diagnose spondylolisthesis, doctors usually start with a physical exam and ask about your symptoms. They often use imaging tests to confirm the diagnosis, such as:

• MRI - To check for nerve compression
• CT Scans - To provide detailed bone images
• X-rays - To view vertebral alignment and grade the slippage

Treatment of Spondylolisthesis

The best course of action depends on the degree of spinal slippage, the severity of the problem, the patient's age, general health, and amount of activity.

Conservative Treatment (Non-Surgical)

Non-surgical treatment is often effective for low-grade slips, such as Grade I or II, particularly when symptoms are mild to moderate. This typically includes rest, physical therapy to strengthen your back and abs, and lifestyle modifications, like steering clear of activities that worsen your symptoms.

Surgical Treatment

Surgery is usually looked at when other treatments don't work or if the condition gets worse, causing intense pain, nerve issues, or difficulty moving. The most common type of surgery for this is spinal fusion.

Additionally, spondylolisthesis treatment costs are way too expensive nowadays. Hence, it is essential to buy a comprehensive health insurance plan from Care Health Insurance. It will give the best coverage plans suited to your needs and budget. 

Physical Therapy Treatment

A customised physical therapy plan can boost spinal stability, flexibility, and core strength. The workouts might include stretching tight hamstrings, strengthening the lower back muscles, and improving posture to ease pressure on the spine.

Bracing

Sometimes, especially for younger folks or those dealing with isthmic spondylolisthesis, a back brace can help by limiting movement in the spine. This gives the injured area a chance to heal and can ease pain while going about daily life.

Medications

Pain relief is often handled with over-the-counter options like nonsteroidal anti-inflammatory drugs (NSAIDs). For more intense pain, doctors might prescribe muscle relaxants or short-term opioids, but they usually steer clear of long-term use.

Epidural Steroid Injections

Corticosteroid injections are recommended for patients with nerve-related pain due to nerve root compression. These injections can quickly reduce swelling and inflammation in the affected area.  

Spondylolisthesis treatment ranges from conservative therapies to surgery, depending on severity and symptoms. But, it has always been said that prevention is better than a cure. So, it is better to take precautions. Let's discuss them.

Preventive Measures

Some types of spondylolisthesis are tough to avoid, but others, like degenerative ones, can be lessened with some proactive choices:

• Exercise regularly to build core strength and flexibility.
• Avoid high-impact sports or use protective gear when playing them.
• Maintain a healthy weight to reduce spinal stress.
• Stay alert to early symptoms and get routine spine checkups if you're at risk.
• Use proper techniques during physical activities, especially when lifting heavy objects.

>>Read More: Brain Tumors: Symptoms, Diagnosis & Treatment

Say Goodbye to Back Pain Today!

Spondylolisthesis can feel like a roadblock, but with the proper knowledge and a targeted spondylolisthesis treatment plan, that roadblock can become a stepping stone to a pain-free future. Whether you're just beginning to notice symptoms or exploring treatment options after diagnosis, early intervention and informed decisions are your greatest allies. 

Disclaimer: The above information is for reference purposes only. Kindly consult your general physician for verified medical advice. The health insurance benefits are subject to policy terms and conditions. Refer to your policy documents for more information.