What's New

Super Antioxidants

Antioxidants

Natural Supplements

Informative

Conditions

Resources

Contact Information

[?] Subscribe To This Site

Spondylolisthesis

What is Spondylolisthesis?

It is an intimidating word at first glance, but all you have to do is break it into four sections: spondy - lo - lis - thesis.

In Greek, the root word "spondylo" means "vertebra" and "listhesis" means "to slip."

It is when one vertebra slips forward over the vertebra below it. Most of the time that happens in the low back (lumbar spine) because that part of your spine bears a lot of weight and absorbs a lot of directional pressures.

In other words, your lumbar spine has to move a lot (rotate in various directions) while carrying your body weight.

A lot of times, this combination can put so much stress on the vertebrae that one of them slips forward.

Some activities make you more susceptible to this disease such as gymnasts, linemen in football, and weight lifters who all put significant pressure and weight on their lower backs.

Movements such as bending half backwards, twisting through the air quickly when doing flips and then landing, absorbing the impact through their legs and low back put substantial stress on the spine, and spondylolisthesis can develop as a result of repeated excessive strains and stress.

The x-ray above gives you a good example of this disease. Look at the area the arrow is pointing to.

You can see that the vertebra above the arrow isn't in line with the vertebra below it. It's slipped forward.

What are the Symptoms?

Many people with this disease are symptom free. Sometimes, it is discovered when the patient has an x-ray for an unrelated problem. However, some patients do have symptoms that range from mild to severe.

Listed below are several symptoms usually related to this condition:

Low back pain and tenderness
Buttock pain
Thigh and leg pain and/or weakness (one or both)
Difficulty controlling bowel and bladder functions
Tight hamstring muscles
Swayback
Walking resembles waddling movements
Protruding abdomen

What are Some Causes of This Condition?

There are several main causes. Doctors have developed a classification system to help talk about the different causes to include:

Type I: This is also called dysplastic or congenital spondylolisthesis. Congenital means that you're born with it. Type I spondylolisthesis, then, is a defect in the articular processes of the vertebra (the part that's supposed to control the movement of the vertebra; your facet joints are made of the articular processes).
It usually happens in the area where the lumbar spine and the sacrum come together: the L5-S1 area. The defect allows the L5 vertebra (your last vertebra in your lumbar spine) to slip forward over the sacrum.

Type II: Also called isthmic, the most common kind. With type II, there's a problem with the pars interarticularis, a particular region of your vertebra. Isthmic spondylolisthesis is divided further:

Type II A: Gymnasts, weight lifters, and football linemen are especially prone to this type.

It's caused by multiple micro-fractures on the pars interarticularis—micro-fractures that occur because of hyperextension (overarching) and overuse. The pars fractures completely in type II A.

Type II B: This type also is caused by micro-fractures. The difference is that the pars don't fracture completely. Instead, new bones grow as the pars heals, causing it to stretch. A longer pars can then cause the vertebra to slide forward.

Type II C: Like type II A, this type has a complete fracture. However, it's caused by trauma. The impact in a car accident could fracture your pars.

Type III: Aging can also cause spondylolisthesis. As you grow older, the parts of your spine can degenerate; they can wear out. Usually your intervertebral discs change first.

The older you get, the less water and proteoglycan content the discs have—and less fluid makes them less able to handle movement and shock. Less fluid can also cause the disc to thin, and a thinner disc brings the facet joints closer together.

Without the disc acting as the cushion, the facets can't control the spine's movement as well, and they become hyper mobile. In time, a vertebra can slip forward because the facets aren't holding it in place effectively as the spine moves.

Type III spondylolisthesis usually happens at the L4-L5 region (the fourth and fifth vertebrae in your low back), and it's more common in women over 50.

Type IV: Similar to Type II C, Type IV involves a fracture. However, it's a fracture of any other part of the vertebra other than the pars interarticularis.

Your facet joints, for example, can fracture, separating the front part of your vertebra from the back part.

Type V: Tumors on the vertebra can also cause spondylolisthesis because they weaken the bones and can cause fractures that split your vertebra, leading to instability and a potential slip.

Type VI: You have this type if surgery caused your vertebra to slip forward. It's also known as iatrogenic spondylolisthesis, and it's caused by a weakening of the pars, often as a result of a laminectomy (a typical back surgery, but Type VI spondylolisthesis isn't a typical result of the surgery).

As a quick summary, spondylolisthesis can be caused by:

a birth defect

fractures

spondylolysis (a defect or fracture in the pars interarticularis)

degeneration due to age or overuse

tumors

surgery

When do I Seek Medical Advice?

It's hard to tell if you have spondylolisthesis because you may not have any symptoms or overwhelming pain, most people don't. It is usually discovered when you're being tested for something else and the doctor notices the slipped vertebra on an x-ray.

If you have increased back pain that lasts for more than two weeks, you need to make an appointment with your doctor.

What are Some Treatments for Spondylolisthesis?

Here are few treatments that should help:

Bracing It may be more difficult for your spine to provide proper support because the vertebrae are out of alignment. That can make your muscles work harder, which fatigues them and can lead to pain. To support your lower back, your doctor may want you to wear a brace or a corset for awhile.
A lumbar brace or corset will compress your abdomen, and that will take some of the pressure off of your spinal column. The goal is to give you some pain relief while at the same time keeping your spine safe as the pars interarticularis fracture tries to heal.

Physical Therapy A physical therapy program is one of the more effective ways to treat spondylolisthesis for two main reasons: it can help strengthen the muscles that support your spine, and it can teach you how to keep your spine safe and prevent further and future injury.
Physical therapy includes both passive and active treatments. Passive treatments help to relax you and your body. They're called passive because you don't have to actively participate.
Your physical therapy program may start with passive treatments to give your body an opportunity to heal, especially if you have a pars interarticularis fracture. However, the goal is to get into active treatments.
These are therapeutic exercises that strengthen your body and help prevent a recurrence of possible pain from spondylolisthesis.

Rest It may seem counterintuitive, but sometimes the most appropriate treatment is no treatment at all. If your vertebra isn't slipping forward any further and if the spondylolisthesis isn't causing pain, you may not need any treatment.
You may need to take it easy for a few days if you have an episode of acute pain. Not too long ago—within the last 15 years—doctors recommended extensive bed rest for back pain.
Their thinking has changed, though, because too much time resting can be detrimental. It can weaken your muscles, for example, which could lead to more back problems. Now, doctors recommend two or three days of bed rest.

Medications To control your pain, your doctor may recommend medication or injections such as over-the-counter medications that include analgesics (Tylenol), and non-steroidal anti-inflammatory drugs (NSAIDs).
These medications have side effects so be sure and read all labels.
Injections are the third option to deal with spondylolisthesis pain, but generally, your doctor won't recommend them until after you've tried over-the-counter and prescription medications.
The most common injection is an epidural steroid injection. This sends steroids—which are very strong anti-inflammatories—right to the nerve root that's inflamed.
You'll probably need 2-3 injections; generally, you shouldn't have more than that because of the potential side effects of the steroids.
The epidural steroid injection can also contain local anesthetics to provide some short-term and immediate pain relief while the stronger steroids start to take effect.

Surgery Spine surgery for spondylolisthesis is a much-debated topic. While most surgeons agree that decompression of the nerves may benefit the patient, the question is whether the slipped vertebra needs to be realigned at all. It depends on what caused the spondylolisthesis.

What are Some Lifestyle and Home Remedies?

It may not be possible to prevent a spondylolisthesis, but eating right, maintaining normal body weight, and regular strengthening exercises are always healthy choices. Here are few to review:

Eat a healthy diet A healthy diet emphasizing fruits and vegetables that are high in antioxidants , and whole grains can help you control your weight and maintain your overall optimal health, allowing you to be able to deal better with your spondylolisthesis.
However, there's no special diet effective for treating it. Researchers are finding out that antioxidant-rich foods such as dark chocolate and many others that can help decrease inflammation in your joints in turn decreases pain.
Inflammation has been linked to both rheumatoid arthritis and osteoarthritis, and a new research also links chronic-inflammation to allergies, asthma, diabetes, digestive disorders, heart disease, hormonal imbalances, and osteoporosis.

Maintaining normal body weight According to the American Obesity Association 64.5% of adult Americans (about 127 million) are categorized as being overweight or obese.
The unfortunate truth is that obesity is becoming a global epidemic affecting adults and children.
Most people know that obesity contributes to the development of coronary heart disease, diabetes , high blood pressure , and colon cancer. However, did you know that obesity is a contributing factor to back pain? It's true. Being overweight or obese can significantly contribute to symptoms associated with osteoporosis, osteoarthritis , rheumatoid arthritis, degenerative disc disease, spinal stenosis , and spondylolisthesis.
Our spine is designed to carry our body's weight and distribute the loads encountered during rest and activity. When excess weight is carried, our spine is forced to assimilate the burden, which may lead to structural compromise and damage (e.g., injury, sciatica).
If you are overweight, obese, or working at maintaining a healthy weight, there are many tools available to empower your efforts.
Here are some Weight Loss Tips and information about the antioxidant properties of Dark Chocolate .

Maintain good posture Unhealthy posture causes uneven weight distribution and may strain ligaments and muscles. The best and easiest way to improve your posture is by walking.
The faster you walk, the harder your muscles must work to keep you upright. A lot of people find that swimming also helps improve their posture.

Information on this site is provided for informational purposes only and is not meant to substitute for the advice provided by your own physician or other medical professional.

Return to Back Pain page from Spondylolisthesis.