Lumbar Spondylolisthesis

Lumbar spondylolisthesis is a condition where one of the vertebrae (bones) in the lower back slips forward out of its normal position onto the bone below it. This slippage can put pressure on the nerves, leading to various symptoms.

There are two main types of lumbar spondylolisthesis:

Congenital Spondylolisthesis: This is a birth defect where the vertebrae do not form properly during fetal development. It most commonly occurs at the L5-S1 level, where the lumbar spine meets the sacrum. One vertebra fails to join properly with the adjacent vertebra, allowing it to slip forward or backward out of alignment. Congenital spondylolisthesis can lead to spinal deformities, narrowing of the spinal canal, and nerve compression.

Degenerative Spondylolisthesis: This type occurs due to aging and wear-and-tear changes in the spine. It is more common in older adults, especially after age 50, and more prevalent in women. Degeneration of the discs, facet joints, and ligaments supporting the spine can cause one vertebra to slip forward over the one below. This slippage often occurs at the L4-L5 level and can compress the nerves, leading to back pain and leg symptoms.

Common symptoms include:

• Persistent lower back pain
• Stiffness and muscle tightness in the back and legs
• Pain, numbness, or tingling in the thighs, buttocks, or legs
• Weakness in the legs
• Tenderness around the area of the slipped vertebra

For mild cases, nonsurgical treatments may be recommended, such as:

• Rest and avoiding strenuous activities
• Pain medication (over the counter or prescription)
• Physical therapy exercises to strengthen the back and improve flexibility

However, for more severe cases or when conservative treatments fail, surgery may be necessary. The main surgical procedure is called spinal fusion, where the slipped vertebra is fused with the adjacent vertebra using bone grafts or synthetic materials. The slipped vertebrae can be returned to its normal position after this procedure. This stabilizes the spine and prevents further slippage.

The key benefit of surgical treatment is that it can effectively relieve compression on the nerves caused by the slipped vertebra, alleviating symptoms like pain, numbness, and weakness in the legs. Spinal fusion also provides long-term stability and prevents progression of the condition.

We would assess how the Spondylolisthesis may have affected other areas of the spine through special total body imaging so that any future areas of concern can be taken into consideration.