Lumbar Spondylolisthesis Treatment

Image illustration of Lumbar spine with parts labelled.

Lumbar Spondylolisthesis: An Overview

Spondylolisthesis is a condition where one of the bones in your spine slips forward over the next bone, thus altering spinal alignment. A slipped bone also causes abnormal movement and friction with each movement. Generally, the grading of Spondylolisthesis is determined by the extent of slippage, known as the Meyerding Classification, occurring between one vertebral body and the neighbouring one. Although most Spodylolisthesis cases are progressives, the compression can lead to progressive damage in higher grades of slip.

Spondylolisthesis commonly occurs in the lumbar and cervical spine areas. For trauma cases, it mainly occurs in the thoracic spine. Degenerative Spondylolisthesis is another type common in osteoarthritic senior citizens. However, there are various other variants of Spondylolisthesis, each attributed to a distinct underlying cause. Surgery for Spondylolisthesis is more straightforward, with less risk and better outcomes in the early stages compared to late/ neglected steps when the bone slippage is more advanced.

Our spine doctors at Spine 360, Bangalore are committed to delivering tailored treatment options for individuals diagnosed with Lumbar Spondylolisthesis.

Lumbar Spondylolisthesis: Risk Factors

Spondylolisthesis is primarily a genetic occurrence. Other common factors include:

Sports - especially gymnasts, weightlifting, football and baseball players

History of frequent repetitive overstretching (hyperextension)

Female population

Overweight and Obesity

Spine trauma

Lumbar Spondylolisthesis: Causes, Symptoms, and Warning Signs

The close-up image of the model of a spine.

Causes

Congenital spondylolisthesis referred as dysplastic spondylolisthesis is abnormality since birth and there is defect in the formation of part of the vertebra called the facet that allows it to slip forward
Isthmic spondylolisthesis is defects in the pars interarticularis – possibility due repetitive trauma – fatigue fracture of pars
Degenerative spondylolisthesis – results due degenerative changes in spine as part of aging process
Traumatic spondylolisthesis - fractures of the pars interarticularis or the facet joint of spine following high velocity trauma

Symptoms

Acute or chronic back pain radiating to the buttocks and thighs is the typical symptom of Spondylolisthesis. You may also experience:

Back pain - commonest symptom - typically worse with prolonged standing, bending and lifting and often relieves on lying down or sitting
Pain in the back while getting up from sitting position
Pain, numbness and weakness in legs (Sciatica) – as the spine becomes unstable and put pressure on nerves (stenosis)
Neurogenic claudication - buttock and leg pain and cramps caused by walking for short distance, but pain subsides on rest
Loss of bowel and bladder function in cases of severe nerve compression

A man suffering from severe low back pain.

Diagnostic Tests for Lumbar Spondylolisthesis

At Spine 360, our tried and tested approach is always to thoroughly examine your spine by applying pressure to various areas to assess sensitivity and discomfort. If needed, our doctors will recommend the following tests for further diagnosis:

A spine expert analyzes an x-ray image of the spine.

X-rays

X-rays reveal slipped lumbar vertebrae and age-related changes like decreased disk height and bone spurs.

Image of a person undergoing an MRI scan.

Magnetic Resonance Imaging (MRI)

MRI scans are recommended when detailed and crystal-clear images are necessary to study the tissues, nerves, and vertebrae. They can provide a more comprehensive illustration of the slippage and identify whether there is any nerve impingement.

Computed Tomography (CT Scan)

The CT scan is mostly recommended for capturing detailed cross-sectional images of your bones.

Non-Surgical Approach to Relieve Spondylolisthesis

The vertebral slippage occurring with Spondylolisthesis is curable only through surgery. However, at Spine 360, we suggest the following methods to find relief from this condition:

Modifying your activity – Restriction of your routine physical activities, this will help to help settle symptoms (avoid sudden repetitive bending)

Physiotherapy – When symptoms are not severe - rehabilitation program will help in reducing pain and inflammation, as well as improving mobility, strengthening spinal musculature and correcting your body posture to reduce back pain

Lumbar belt / corset – short term relief – harmful when used for prolonged time

Medication - important role in easing pain and muscle spasms

No role of traction

Lumbar Spondylolisthesis: Surgical Treatments at Spine 360

At Spine 360, our doctors will only decide on these various surgical options when all other options fail to elicit the desired results.

Indications for surgery in patients who have spondylolisthesis:

Grade 2 and above slippage
Progressive spondylolisthesis - Slippage that is progressively worsening
Leg pain at rest
Back pain that has not improved after a period of nonsurgical treatment
Significant reduction of quality of life

Surgical Options:

Decompression

When the spine is stable and in stable grade I listhesis, this procedure is done to relieve compression on nerves. It is performed by removing a small amount of bone and disc to open the space for the nerves within the spinal canal.

Spinal fusion

This procedure is done when there is progressive slippage and grade 2/more. The goal is to prevent further progression of slippage, to stabilize the spine and provide relief. Can be performed from back (TLIF), side (XLIF, OLIF) and from front (ALIF). The necessity of spinal fusion is to eliminate motion between vertebrae and make the spine stable. The fusion is performed with screws, rods and cages to stabilize the vertebral bodies. Cages are filled with bone graft for fusion.

Both the surgeries are performed under general anesthesia in minimal invasive fashion. Decompression requires a 2 cm incision in the back, whereas fusion requires multiple small incisions.

What can I expect after surgery?

Most patients are usually in the hospital 1-3 days in the hospital. Patients are usually up and walking the day after surgery. Return to activities is based patients general condition, wound healing and surgeon’s recommendations.

Do Not Postpone Your Recovery

Talk to our doctors today. Get the best possible medical solutions and personalised care only at Spine 360.