We tend to think of slippage in the spine in regards to a slipped disc, but spondylolisthesis is when a vertebral bone slips out of alignment in the spine. The farther down it slips, the more discomfort and effects it can cause. If the vertebra places pressure on an adjacent nerve, it can cause a lot of pain.
Many people with spondylolisthesis do not even realize they have it, as they remain asymptomatic. When symptoms do happen, they usually manifest as lower back pain that radiates and feels similar to lower back strain.
In severe cases, it can cause muscle spasms in the hamstrings – in the back of the thigh. If the spondylolisthesis is pressing on a nerve in the lower back, it can cause pain to radiate all the way down to the foot; this can make the foot feel like it’s asleep, or a pins-and-needles sensation.
Types of Spondylolisthesis
There are several kinds of spondylolisthesis:
- Congenital spondylolisthesis is caused by abnormal bone formation in the mother’s womb and is present at birth.
- Isthmic spondylolisthesis is a result of spondylolysis, a condition that causes small stress fractures in the vertebra – sometimes resulting in it or a piece of it slipping onto the vertebra below.
- Degenerative spondylolisthesis is the most common type, and it is caused by the normal aging process. The discs dry out, failing to cushion the back like before.
- Traumatic spondylolisthesis is when an injury causes a spinal fracture or slippage of the vertebra.
- Pathological spondylolisthesis occurs when disease weakens the spine, such as osteoporosis, infection, or tumor.
- Post-surgical spondylolisthesis is when the vertebral slippage occurs or worsens following surgical intervention.
A doctor will give you a physical exam to pinpoint where the pain is coming from. They then likely will order an imaging exam, such as an X-ray, to check the disc height, its relative position, and whether bone spurs are present.
The physician will usually ask for flexion-extension images, where you will lean forward and backward to reveal any spinal instability. The doctor might also order an MRI to reveal inconsistencies in the muscles, discs, nerves, and spinal cord, and can reveal if and where any nerve is pinched.
Is Treatment Available?
Treatments for spondylolisthesis start with conventional medication, physical therapy, and rest. If your condition does not improve, your doctor may try a nerve block in the spine to try to reduce the pain.
If after six months you do not show any signs of improvement, your doctor will likely suggest surgery. This may require a spinal fusion in order to reduce or eliminate your pain.
Neurosurgeons in Colorado
If you or someone you know is having similar symptoms, it is best to see a neurosurgeon. A neurosurgeon focuses on the brain and spine, so this type of doctor knows how to treat delicate spinal conditions without causing unnecessary harm.