Spondylolisthesis is a condition that is characterized by the spine moving forward. In most cases, this phenomenon affects the lower spine, especially at the junction between the lumbar spine and the beginning of the sacral spine vertebrae. A displacement between the fourth and fifth lumbar vertebra is the most common: this is called L4-L5 spondylolisthesis. The cause may be:
- a defect in bone formation on the sides of the vertebrae;
- damage to the vertebral disc, as is frequently seen in osteoarthritis;
- rarely, a fractured vertebra.
Spondylolisthesis may be liable for no symptoms, not generate any pain, and discovered via an imaging examination performed for another reason, often a spine radiograph. Sometimes, however, it causes severe pain, unrelated to the severity of the vertebral slip. Pain is an important criterion for determining the establishment of treatment or not.
Lumbar spondylolisthesis, by far the most common form, results in:
- back pain, depending on to the area affected;
- pain in the sciatic nerve that starts in the buttocks and travels down along the side of the leg or on the rear side of the leg, sometimes all the way to the big toe, through the top of the foot or only affecting the fifth toe and heel via the lateral edge of the foot.
- These pains are increased during movement, and are reduced during rest.
A clinical examination is not sufficient to confirm the presence of spondylolisthesis, and must be supplemented by a front and sideways X-ray of the affected area of the spine, or by scanner or MRI.
The treatment is prescribed depending on the pain experienced by the patient. In addition to an analgesic or anti-inflammatory drug to take for pain, physical therapy is prescribed in order to build up the lumbar muscles but also the abs. The patient may be prescribed bed rest for a few days with a temporary brace, but he should resume normal activity ASAP, while still avoiding certain sports. Surgery is necessary in case of the serious displacement of a vertebral disc or when the risk of worsening is serious.
Some sports such as weightlifting or contact sports can foster spondylolisthesis. Monitoring of children and adolescents with lumbar or low back pain may allow for an early diagnosis of spondylolisthesis.
Original article published by
. Translated by Jeff