What is Spondylolisthesis?

The vertebrae composing our spinal column are typically aligned in a precise manner in individuals with good health. The edges of these vertebrae are meticulously positioned in relation to the ones preceding and succeeding them. This harmonious alignment among the spinal bones not only enhances flexibility but also fortitude. When referring to spondylolisthesis in the lumbar region, it denotes a condition where slippage of the spine or lumbar region, often termed as a slipped disc in the waist, is observed. In such instances, one of the vertebral bones shifts anteriorly compared to its counterpart, thereby exerting pressure on the spinal cord and the nerve roots emanating from it, consequently manifesting symptoms associated with lumbar slippage.

There are various factors that contribute to the development of spondylolisthesis. These include age-related degeneration, congenital abnormalities, trauma, infections, surgical procedures, or tumors. The displacement of the lumbar vertebrae is predominantly observed between the lumbar spine segments L4-L5 and the sacral region encompassing L5 and the sacrum.

What are the Symptoms of Spondylolisthesis?

The manifestations of lumbar displacement vary depending on the severity of the disease. Predominant symptoms encompass intense discomfort in the lower back and hip area. Additional common signs entail the necessity to intermittently pause and attend while ambulating, extended periods of immobility either standing or sitting, and sensations of numbness in the lower extremities. Given the detrimental impact of these manifestations on the patients' daily routines, requisite diagnostic evaluations are arranged.

How is the Diagnosis of Spondylolisthesis Established?

When diagnosing Spondylolisthesis within the spinal region, the initial step involves attentively listening to the patient's complaints. Various imaging modalities, such as MRI, computed tomography (CT), and X-ray, are utilized in accordance with the presenting symptoms. These imaging techniques provide comprehensive views of the spine from various perspectives. During the diagnostic phase, the mobility of the spondylolisthesis is also assessed. In cases where the condition is non-mobile and does not pose significant issues for the patient, surgical intervention may not be deemed necessary.

What are the Types of Spondylolisthesis?

• Congenital (Dysplastic) type
• Degenerative type: It is the most common type. It occurs with the progression of age, with the sliding of the existing tissues in and around the spine on each other.
• Isthmic type
• Traumatic: In cases of acute traumatic spondylolisthesis due to accidents, pain increases while standing and with movement.
• Pathological
• Iatrogenic

What are the Treatment Methods for Spondylolisthesis?

According to the extent of lumbar slippage in individuals presenting with low back pain and diagnosed with spondylolisthesis, treatment commences with a regimen encompassing rest, analgesics, orthotic support, physical therapy, and other palliative modalities. These therapeutic interventions aim to alleviate the symptoms experienced by patients, even those whose symptoms persist despite initial treatments. In cases where conservative measures prove ineffective, surgical intervention is advised. Surgery is commonly indicated for individuals with significant lumbar slippage, particularly those presenting with leg pain rather than solely low back discomfort, accompanied by neurologically ascertained muscle weakness or nerve dysfunction.

For instance, a patient diagnosed with spondylolisthesis may initially undergo a period of rest to reduce strain on the affected area, coupled with the use of analgesics to manage pain. Additionally, orthotic support such as a back brace may be prescribed to provide stability and promote proper alignment of the spine. Physical therapy plays a crucial role in strengthening the surrounding muscles and improving flexibility, which can contribute to long-term pain relief and functional improvement.

In situations where conservative treatments fail to yield significant improvements, surgical options become a consideration. Surgical intervention may involve procedures aimed at stabilizing the spine, such as spinal fusion, to address the vertebral slippage and alleviate pressure on the nerves. It is essential to carefully assess the individual's symptoms and overall condition to determine the most appropriate course of action. Patients with severe lumbar slippage and neurological deficits may benefit the most from surgical procedures, especially if they experience persistent leg pain or muscle weakness that significantly impacts their quality of life.