What is spondylolisthesis?
Spondylolisthesis can be a painful condition of the back caused by a vertebrae from the lower spine slipping out of position.
This is a separate condition to a slipped disc where a spinal disc between the vertebrae becomes ruptured or prolapses.
Causes of spondylolithesis
There are many causes of spondylolisthesis. A vertebra might be defective from the time a person is born, or a vertebra might be broken by trauma or a stress fracture. In addition, vertebrae can be broken down by infection or disease. Most commonly, this disorder occurs in children and adolescents who are active in sport and athletics.
In adults, it is often caused by wear and tear from ageing of the spine or a degenerative disease such as osteoarthritis.
Symptoms of spondylolithesis
- Lower back pain
- Muscle tightness and stiffness including tight hamstring muscles
- Pain in the buttocks and thighs
- Pain radiating down the legs ( sciatica due to pressure on nerve roots)
- Tenderness around slipped vertebra
Seek medical advice if you have persistent back pain, stiffness, persistent buttock or thigh pain or if your back curves excessively.
If uncorrected, spondylolisthesis may result in kyphosis in which the top of the back is excessively curved and looks more rounded than is normal.
As well as a physical examination, a doctor will usually ask a patient to do a straight leg raise. This is often painful for people with spondylolisthesis.
An X-ray of your spine (taken when you are standing) will show if one of your bones is out of place, and whether you have a fracture.
Treatment will depend on how severe the condition is in a person.
Anti-inflammatory painkillers may be recommended to reduce back pain. Bed rest is another option.
Exercises for strengthening the supportive abdominal and back muscles through physiotherapy may help.
For patients who continue to have severe pain and disability after physiotherapy, there is the option of surgical fusion ( arthrodesis) of the vertebra to the bone below.
This operation does involve the risk of nerve injury, so a doctor will discuss the risks and benefits before recommending this approach.