The word “Spondylolisthesis” is derived from two Greek words, “spondylos” which means spine and “listhesis” which means slippage.
Spondylolisthesis is a condition that can lead to chronic back pain and associated symptoms. The condition involves a slippage of the anterior or posterior part of the vertebra in relation to the adjacent vertebra below it.
The condition is not common in adults, but it represents a common cause of back pain in adolescents. It usually occurs in the lower back, especially at the L4 and L5 vertebrae, though it can also occur at other points along the spine.
It can be very painful and debilitating for some people.
Types of Spondylolisthesis
The condition is divided into six types:
This condition happens when there is a fracture in the spinal cord tissues that join two larger parts of the spine. It is the most common occurrence and occurs mostly in football players and other sports or activities that apply stress on the lumbar part of the spine.
The patient might not feel pain, especially when the joints don’t slip away from their places.
The major cause of this condition is arthritis of the vertebral joints. This makes them weak and the patient feels a lot of pain due to the loosening of the joints. This condition is common in the older adults due to the degenerative processes that start in old age. At this stage, the condition can make the backbone unstable which affects the functions of the disc joints.
This is a deformity of the bone structure, whereby the spinal vertebrae slips away. The condition is inherited and the symptoms start appearing at birth. It is also called Dyspastic Spondylolisthesis.
If you are suffering from a tumour or osteoporosis, you can have pathological Spondylolisthesis. The reason for the condition is invasion of the body by pathogens. The type is not as common as the other two types mentioned earlier.
This occurs after surgery performed to the back. In this case, the vertebrae leave their place. This usually happens when the joints move back and forth after the surgical procedure.
This happens due to spinal trauma where the impact affects the structure of the backbone and displacement occurs. This can also happen in strenuous exercises.
Symptoms of Spondylolisthesis
Symptoms of this condition aren’t so obvious, but the main symptom is pain in the lower back. The pain might spread to other areas of the body. It might be accompanied with difficulty in walking or worse, he might lose bladder control.
Radiologists have categorised the condition into four degrees depending on the level of slippage:
Grade I – between 1 and 25 percent slippage
Grade II – between 26 and 50 percent slippage
Grade III – between 51 and 75 percent slippage
Grade IV – between 76 and 100 percent slippage
The first two grades aren’t severe, and don’t necessitate surgery. The patient can get relief through physiotherapy or the use of braces, exercise, home remedies and painkillers. Grades III and IV are severe and the patient has to undergo surgical treatment. Diagnosis is usually via X-ray, MRIs and CT scans.
Other symptoms include:
- Lower back pain that is chronic in nature
- Localized tenderness in the spine at a point above the pelvis
- Pain that radiates to the thighs and the buttocks
- Tense hamstring muscles
- Stiffness in the back
- Loss of bladder and bowel function
This condition occurs in all age groups, which means you need to be wary of the symptoms and go for treatment when you realize that something is amiss.
References and Further Reading
1. Lumbar Spondylolysis and Spondylolytic Spondylolisthesis: Who Should Be Have Surgery? An Algorithmic Approach
2. Lumbar degenerative spondylolisthesis epidemiology: A systematic review with a focus on gender-specific and age-specific prevalence
3. Adult Isthmic Spondylolisthesis