What is Spondylolisthesis?
A spinal condition affecting the lower vertebrae of the spine, Spondylolisthesis disease causes one of the lower vertebrae to slide forward , pressing directly into the vertebrae, nerve, or bone beneath it. Most patients describe Spondylolisthesis as an uncomfortable or painful condition. As for specific symptons, in general, Spondylolisthesis results in pain in the patients legs when they walk or stand for extended periods of time. Rest assured, most neurosurgeons and spinal specialists consider Spondylolisthesis easily treatable in most cases. If a patient receives a Spondylolisthesis diagnosis, there’s no need to panic. Spondylolisthesis can certainly be an annoyance—sometimes a major one—but it is most commonly, not dangerous.
Most neuorsurgeons recommend that patients with Spondylolisthesis avoid high impact or strenuous activities that might add pressure to the lumbar (or lower) spine. Patients should refrain from heavy lifting, sports such as gymnastics, football, competitive swimming, and diving, and intense cardio until receiving full medical clearance from their spinal provider.
What are the different forms of Spondylolisthesis?
Generally speaking, Spondylolisthesis occurs in a few forms. Spondylolisthesis derived from a traumatic event often occurs after a high-impact or force injury results in the movement of the vertebrae or slip. Pathological Spondylolisthesis occurs when a disease — such as osteoporosis — or tumor causes the condition. Post-surgical spondylolisthesis is slippage as a result of spinal surgery. With Isthmic spondylolisthesis, a condition where one of the vertebrae slips over the vertebrae below it, patients often report difficulty finding comfort sleeping or in various sitting positions. Reclining helps because it causes an angle between your thighs and your trunk, reducing pressure on the spine. Sleep on your side with a pillow between your knees.
How is the spinal condition of Spondylolisthesis treated?
Physicians typically treat Spondylolisthesis through a series of medical progressions. Some patients respond favorably early in the protocols and do not require advanced treatment. These modalities include
- Medications to manage the Pain,
A low grade painkiller such as acetaminophen, and/or NSAID’s (i.e. ibuprofen) or oral steroids to reduce inflammation
- Heat and/or ice
- Physical Therapy
- Manual manipulation
- Epidural steroid Injections
- Spondylolisthesis Surgery
Spinal fusion surgery for a degenerative spondylolisthesis typically has incredibly successful results, with more than 90% of patients improving function and enjoying substantial reductions in pain levels and discomfort. ALIF, PLIF, and TLIF can all be performed by physicians minimally invasively. For spondylolisthesis surgeries, many neurosurgical surgeons combine the use of different minimally-invasive and open procedures in a technique called “mini open.”
For 8 to 12 weeks following surgery, patients should limit physical activity and sport to low strenuous, no-impact movements as the spine fuses and recovers. Equally critical, patients should remain mobile for the surrounding joints and muscle to develop. As always, please consult your neurosurgeon directly with questions and return to work/sport protocols.