What is Spondylolisthesis?
Spondylolisthesis is a degenerative spinal disorder which occurs when one of the vertebrae slips ahead of the one below it. This is usually the result of aging as it progressively weakens the bones and ligaments surrounding and supporting the spine.
This spinal disorder is found to be more common in people above the age of 50 years and women are at more risk of developing it as compared to men of the same age-group.
This degenerative Spondylolisthesis is usually seen occurring in the lower (lumbar) region of the spine and is rarely found at any other level. It is also known to occur at 2-3 levels simultaneously. Cervical (upper) spine Spondylolisthesis is a rare disorder and occurs in the neck region.
What causes Spondylolisthesis?
The spine is made up of several vertebrae stacked one on top of the other. These vertebrae are divided by inter-vertebral discs that help to cushion the weight as well as provide smooth movement between the consecutive vertebrae. The spine starts at the upper neck region just below the skull and ends at the tail-bone in the lowest region of the back.
As the vertebrae slowly degenerate with disease they can become incompetent and allow for excessive movement in the spine. This causes one vertebra (usually in the lower back) to slip ahead of the one just below it.
How is Spondylolisthesis diagnosed?
Spondylolisthesis is diagnosed using:
- Medical History – A check of the medical history allows the doctor to review the symptoms as well as identify factors that make the symptoms better or worse.
- Physical Examination – This help the doctor to determine the range of restriction in the motion of the back as well as the weakness in the muscles and other neurological symptoms.
- Other Tests – X-ray tests are used to help identify the exact slipped vertebra as well as rule out any other reason for the symptoms. MRI scans are also used to study the slipped vertebra and its surrounding ligaments more closely.
What are the Signs and Symptoms of Spondylolisthesis?
The vertebral facets get larger as they start to degenerate and can often extend into the spinal canal causing in spinal stenosis. These are the signs and symptoms that are commonly seen in case of Spondylolisthesis:
- Lower back pain
- Sciatic pain (one/both leg aching after prolonged exercise)
- Intense pain in the back when standing for a long time
- Tightened thigh muscles at the back
- Leg weakness
How is Spinal Fusion for Spondylolisthesis performed?
The spinal fusion surgery is the most common and successful surgical treatment method for Spondylolisthesis. It requires the surgeon to administer general anesthesia in order to prevent pain or discomfort to the patient during surgery.
The surgery aims to weld (fuse) together the slipped vertebrae together in order to provide stability. The surgeon will make a small incision over the slipped vertebra in the back. Using minimally invasive surgical techniques the surgeon will use a piece of bone graft (usually harvested from the patient’s hip bone) to be transplanted between the slipped vertebra and the one below it. As the bone heals the bone graft is incorporated by both the vertebrae and they become one complete bone mass. This helps to restrict the movement in the damaged vertebra and relieve the resulting pain. It helps to stabilize the spinal column as well.
In some cases, the orthopedic surgeon will also use surgical metal screws, plates and rods to hold the vertebra together as the fusion heals.
How is Recovery after a Spondylolisthesis Treatment?
The severity of the slip by the vertebra is known to determine if the Spondylolisthesis occurs again. In case of a minor slip the pain might not be seen again.
Spinal fusion surgery in India for Spondylolisthesis has been found to be successful in completely treating the pain and disability in around 85-90% of all cases.
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