Spondylolisthesis Spondylolisthesis is the medical term used to describe the slipping of vertebrae within the spinal canal. The human spine is a perfectly uniform S-shape, but a slip distorts this shape. In spondylolisthesis, the spine (vertebrae) slides forward or backward over the vertebrae below. Slippage can be classified (categorized) into five different types: degenerative, isthmic, developmental abnormalities/congenital, disease-induced, and trauma-induced slippage. 5 types of slippage 1. Degenerative slippage of the spine: the most common degenerative disease causing it. It is usually present in the elderly and is especially common in African Americans. 2. Spondylolisthesis of the isthmus: affects adults and children. It is usually caused by a small break in the isthmus (part of the articular eminence) of a joint. 3, Dysplastic spondylolisthesis: Also known as congenital spondylolisthesis, it is the result of a congenital birth defect. 4, pathogenic slippage: this form of spondylolisthesis is caused by disease, such as a tumor or infection. 5, traumatic (traumatic) slippage: a fracture resulting from a traumatic event Spinal slippage grade The severity of slippage is determined by the degree of slippage, or the percentage of slippage of one vertebral body versus another. The higher the slippage grade, the more severe the symptoms. Each of the four slippage grades represents 25% slippage. Although slippage from the spine can occur anywhere in the spine, slippage in the low back is the most common and is the primary source of back pain. Even in many cases, symptoms of slippage can be improved with non-surgical treatment, but severe slippage may require surgical treatment. Symptoms and causes of lumbar spondylolisthesis The symptoms of lumbar spondylolisthesis vary greatly from patient to patient and can vary from mild to severe in presentation. Some patients with lumbar spondylolisthesis may not even have any symptoms. In the early stages of the disease, symptoms may manifest themselves only as painful sensations in the neck or back after activity. You can also check out our treatment page for more information. Cervical spondylolisthesis 1. localized pain or radiating pain in the shoulder and upper extremity; 2. muscle tension or stiffness; 3. localized pressure and pain in the slipped segment; 4. decreased neck mobility; 5. numbness or tingling in the upper extremity; if not treated promptly, it may lead to decreased muscle strength in the upper extremity. Lumbar spondylolisthesis 1, localized pain or radiating pain in the back, buttocks and/or thighs; 2, muscle tension or stiffness; 3, localized pressure and pain in the slipped segment; 4, decreased mobility in the low back; 5, numbness or tingling in the lower extremities; if not treated promptly, it may lead to decreased muscle strength in the lower extremities. Causes of spondylolisthesis: Spondylolisthesis may be secondary to degenerative disease, fracture, congenital malformation, pathological bone loss, and traumatic injury. The symptoms of spondylolisthesis then arise from a slipped displacement of the spine. If the spinal slippage occurs in the cervical spine, you will feel symptoms in the shoulders, upper extremities, and hands. When a slip occurs in the lumbar spine, you will feel symptoms in the lower back, buttocks, and thighs. Treatment of Spondylolisthesis: The first occurrence of spondylolisthesis should be treated conservatively before resorting to aggressive surgical intervention. Conservative (non-surgical) treatment of spondylolisthesis includes physical therapy of the core muscles, application of anti-inflammatory medications, epidural injections, brace immobilization and strict bed rest. Conservative treatment methods such as rest and local braking can help relieve the symptoms of spondylolisthesis. Functional exercise, on the other hand, can be very helpful in strengthening and rebuilding spinal stability. In addition, epidural steroid injections and selective nerve root blocks can be used to relieve and eliminate the periodic sterile inflammation that occurs in the slipped segment. Through the use of the most advanced adjunctive tests and diagnostic tools, we will work with you to create an individualized spinal slippage treatment plan. The location of the spinal slip, its severity, and how much it affects your symptoms in your daily life will help us determine what spinal slip treatment plan is best for you. With our guidance, you will get the right treatment for your condition. Timing of surgery for spondylolisthesis: Surgery for lumbar spondylolisthesis should be considered if conservative treatment fails to produce positive results after 6-8 weeks or if the patient’s quality of life does not improve directly. Surgery is indicated prior to conservative treatment for patients with pre-existing neurological dysfunction, impaired bowel or bladder function, or progressive worsening of muscle weakness symptoms. In addition, surgical treatment should be considered if one or more of the following conditions are present: 1. significant displacement of the slipped vertebrae by more than 50% of the adjacent vertebral facets; 2. significant deformity in physical appearance; 3. walking gait disturbance or pain in the legs. Diagnosis of spondylolisthesis: Similar to most other conditions that cause back symptoms, there are three steps to diagnose spondylolisthesis. First, your doctor will need to take a medical history to discover when the first pain or other symptoms occurred, whether there is a genetic history in your family, or what caused your current injury. You should also let your doctor know if there are specific positions that can increase or decrease your pain, or what you have done on your own to reduce your symptoms. Next, your doctor will perform a physical examination to assess your spine’s range of motion, flexibility and other physical symptoms. Finally, your doctor will also check muscle strength and go through some tests to check your nerve function. Imaging for spondylolisthesis: Because spondylolisthesis affects the spinal sequence, a simple x-ray can confirm the diagnosis when you are suspected of having this condition. If there is existing soft tissue damage, an MRI can provide a better diagnosis.