Spondylolisthesis occurs when one or more of the spinal vertebrae shift out of position and press on the vertebrae below it. This can happen anywhere along the spinal column. Common causes of spondylolisthesis include degeneration of the spinal discs, sports injuries, trauma such as a fall or accident, conditions like osteoporosis that affect bone health, and family tendencies to having the condition.
Three common types of spondylolisthesis are as follows:
Degenerative Spondylolisthesis
The most common type of spondylolisthesis is degenerative spondylolisthesis. It often occurs in the lumbar spine. The misalignment of the vertebrae is attributed to age-related changes of the spinal discs between the vertebrae, osteoarthritis of the facet joints, and loss of strength of the supporting muscles and ligaments. Postmenopausal women are more likely to develop the condition.
People with degenerative spondylolisthesis often have spinal stenosis, a narrowing of the spinal canal. They often experience pain in the low back due to the pressure on the spinal nerves. Pain may also radiate into the buttocks and down the leg (sciatica). There may be weakness, tingling, or numbness in the leg or foot. Standing and walking may increase the pain, and sitting may relieve pain. Many patients are successfully treated with conservative care, with surgery only necessary in severe cases.
Isthmic Spondylolisthesis
In isthmic, or spondylolytic spondylolisthesis, the vertebra slips forward because of a structural defect in the bone. A fracture of the pars, which connects the upper and lower facet joints on the back of the vertebra, allows the vertebra to slip out of its normal alignment. Isthmic spondylolisthesis most often occurs in the low back. Some people have no symptoms while others experience symptoms similar to degenerative spondylolisthesis.
Younger athletes may experience this type of spondylolisthesis due to repetitive stress and high impact activities. Higher risk sports include football, gymnastics, weightlifting, volleyball, and cheerleading. The condition is generally managed with conservative care including rest, physical therapy, and bracing. Athletes should eventually be able to return to their sport.
Congenital Spondylolisthesis
Some babies are born with congenital, or dysplastic, spondylolisthesis. Their vertebrae failed to develop properly in the womb. This most often occurs where the lumbar spine and the sacrum meet. The structural weakness in the spine can result in a misalignment of the vertebrae. Congenital spondylolisthesis may cause problems right away or at a later time. Most children with congenital spondylolisthesis can be treated conservatively and will not need surgery.
Atlanta Brain and Spine Care
The Board Certified neurosurgeons at Atlanta Brain and Spine Care are experts in the diagnosis and treatment of spondylolisthesis. Contact us to schedule an appointment with a specialist.
