Have you ever wondered what will happen when you do not have a spine? We humans probably have weird body shapes and we may be unable to actually stand up straight. Medicine is often needed when there is something wrong with the spine. Conditions such as spondylolisthesis can be a great concern. We will learn more about spondylolisthesis in this article.
Spondylolisthesis is the displacement of vertebrae of the spine. In other words, spondylolisthesis occurs when there are slips of one vertebral bone in respect to the adjacent vertebral body. In simple words, spondylolisthesis is a condition where one of the vertebrae moves out of place. What exactly is vertebra mentioned here? It is the small bones that are stacked to form the spinal canal. The vertebrae surround the spinal cord and protect it. Humans have 33 vertebrae which includes 7 cervical, 12 thoracic, 5 lumbar, 5 sacral and 4 coccygeal.
Spondylolisthesis commonly occurs in the lower lumbar spine but it can occur in cervical spine. It is quite rare for thoracic spine to be affected but is possible in case of trauma. Degenerative spondylolisthesis occurs in adults. Isthmic spondylolisthesis is common in adolescent and young adults but often goes unnoticed until they reached adult. Dysplastic spondylolisthesis is common in the paediatric population. In general there are 5 major causes for spondylolisthesis which are degenerative (changes in spine due to ageing process), isthmic (typically microtrauma from sports), trauma, dysplastic (congenital which means at birth) and pathologic (tissue disorder including infection, malignancy or from medical procedure). One of the common cause is degenerative in adults and congenital or isthmic in children,
Symptoms can be mild to severe. At times, there may even be no symptoms until the person reached adult age. In general, most patients have low back pain. The pain will be intense or getting worse with movement such as flexing or extending the spine after a physical activity. Pain may also be more prominent when the areas affected are touched. Pain at times may get better in certain positions such as lying down. Such improvement is made possible as lying down reduces the pressure placed onto the spine that is affected. Other symptoms include buttock pain, numbness, weakness in the leg and difficulty walking. In rare cases, a person may lose control over bowel or bladder movement.
Diagnosing spondylolisthesis initially starts with medical history and physical examination. Medical history will include how the symptoms are and the way it affects the person with a history of possible trauma or activity that may contribute to the pain. Physical examination on the spine is usually done by a patient lying down and raising leg to see for the pain. Doctors may also push the affected area to see for pain or limitation of movement. Once there is suspicion of spondylolisthesis, doctors usually proceed with an imaging test. Imaging tests usually start with x-ray before moving on to other imaging modalities such as MRI or CT scan.
Treatment is provided to help relieve symptoms. It is important to note that treatment may not repair the vertebrae that are affected. Common treatments include physical therapy or exercises to strengthen the lower back, medication such as pain relief and non-steroidal anti-inflammatory drugs (NSAIDs) to relieve pain and steroid injection to reduce numbness with pain sensation. Surgery is often reserved as the last option when nonsurgical treatment fails to provide relief. However, the nonsurgical approach may be used following the surgery. Common surgery done is spinal fusion which is joining the bone or lumbar decompression to relieve pressure onto the compressed spinal nerve.
Patients who are diagnosed with spondylolisthesis may wonder what is actually the best treatment for their condition. The best treatment is the nonsurgical approach as it does not take long time to recover such as in surgery. However, patients should always consider that even if they are needed to go for surgery, it is because it is the best option for their case. At the end of the day, what is best for the patient is determined by their doctor as the doctor knows what is best for them based on their evaluation and consideration.
The best way to actually deal with spondylolisthesis is to take preventative steps to reduce the chances of it happening or slow down the progression of the disease. Regular exercises, maintaining healthy weight and practising a healthy balanced diet are among things that can reduce risk for developing spondylolisthesis. It is best to ask for an exercise plan from a physical therapist. Maintaining good posture when standing and sitting can do a lot for spine health. Limiting activities or sports that put heavy stress or pressure on the lower back such as twisting, lifting and bending is recommended. Learn how to lift heavy objects correctly and carefully. It is important to wear protective gear when participating in sports and learn the right way of doing it to reduce risk for injury.
