Definition
Spondylolisthesis is a condition in which a bone (vertebra) in the lower part of the spine slips forward and onto a bone below it.
Symptoms
- Lordosis
- Lower back pain
- Localized tenderness over the spine just above the pelvis
- Pain in thighs
- Pain in buttocks
- Tight hamstrings
- Stiffness in back
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Definition
Spondylolisthesis is a condition in which a bone (vertebra) in the lower part of the spine slips forward and onto a bone below it.
Symptoms
- Lordosis
- Lower back pain
- Localized tenderness over the spine just above the pelvis
- Pain in thighs
- Pain in buttocks
- Tight hamstrings
- Stiffness in back
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Causes
In children, spondylolisthesis usually occurs between the fifth bone in the lower back (lumbar vertebra) and the first bone in the sacrum area. It is often due to a birth defect in that area of the spine.
In adults, the most common cause is degenerative disease (such as arthritis). The slip usually occurs between the fourth and fifth lumbar vertebrae.
Other causes of spondylolisthesis include stress fractures (commonly seen in gymnasts) and traumatic fractures. Spondylolisthesis may occasionally be associated with bone diseases.
Spondylolisthesis may vary from mild to severe. It can produce increased lordosis (swayback), but in later stages may result in kyphosis (roundback) as the upper spine falls off the lower spine.
Symptoms may include lower back pain and pain in the thighs and buttocks, stiffness, muscle tightness, and tenderness in the slipped area. Neurological ...
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Treatment
Treatment varies depending on the severity of the spondylolisthesis. Most patients require only strengthening and stretching exercises combined with activity modification (avoiding hyperextension of the back and contact sports). Some practitioners also use a rigid brace.
For cases with severe pain not responding to therapy, if the slip is severe, or there are neurologic changes, the slipping vertebra might be surgically fused. This surgery has a higher incidence of nerve injury than most other spinal fusion surgeries. A brace or body cast may be used after surgery.
Possible Complications
- Nerve compression
- Temporary or permanent damage of spinal nerve roots, which may cause sensation changes, weakness, or paralysis of the legs
- Chronic back pain
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Outlook (Prognosis)
Conservative therapy for mild spondylolisthesis is successful in about 80% of cases. When necessary, surgery produces satisfactory results in 85 - 90% of people with severe, painful spondylolisthesis.
Prevention
People with marked lordosis should avoid back hyperextension (leaning way back), weight lifting, and contact sports. Lower back pain, although common in preadolescent and adolescent children, should be evaluated -- especially in the presence of marked lordosis.