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LUMBAR SPONDYLOLISTHESIS - DON'T LET BACK PAIN LAY YOU UP

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Lumbar Spondylolisthesis is a structural abnormality of the spine in which a bone (vertebra) in the lower part of your spine slips forward in relation to the one below it. This forward slippage can cause low back pain and leg pain.

The Greek origin of this word is “spondylos,” meaning vertebra, and “listhesis,” which means slippage.

Spondylolisthesis is officially categorized into five different types by the Wiltse classification system: Dysplastic, Isthmic, Degenerative, Traumatic, and Pathologic.

For a detailed description of Isthmic Spondylolisthesis click here

Spondylolisthesis doesn't seem to be congenital (present at birth), but develops during childhood or later in life. The disorder may result from physical stresses to the spine from carrying heavy things, weightlifting, football, gymnastics, trauma, or general wear and tear.

A type of spondylolisthesis that doesn’t usually occur until after the age of 50 is degenerative spondylolisthesis.This may create a narrowing of the spinal canal (spinal stenosis). This condition is often treated with surgery.

Symptoms of Spondylolisthesis can vary from no pain at all, to severe back and leg pain or stiffness.




Symptoms of Lumbar Spondylolisthesis

• Lower back pain

• Leg pain

• Hamstring muscle tightness

• Numbness and tingling in the legs

• Increased low back curvature (swayback)

Nerve damage (leg weakness or changes in sensation) may result from pressure on nerve roots and may cause pain radiating down your legs.

Causes of Lumbar Spondylolisthesis

Causes of spondylolisthesis include trauma, degenerative arthritis, tumors, and birth defects. Repetitive low back hyperextension, common in gymnastics, diving, weightlifting and polevaulting, is thought to cause a defect in the vertebrae which leads to lumbar spondylolisthesis in greater numbers than the general population.

Athletic activity resulting in greater spinal mechanical stress is related to the development of spondylolisthes.

In children, spondylolisthesis usually occurs between the fifth bone in the lower back (lumbar vertebra) and the first bone in the sacrum area. It is often due to a birth defect in that area of the spine. There may be gradual slipping, but the onset of pain can be sudden and severe.

In adults, the most common cause is degenerative disease (such as arthritis). The slip usually occurs between the fourth and fifth lumbar vertebrae.

Other causes of spondylolisthesis include stress fractures (commonly seen in gymnasts) and traumatic fractures. Spondylolisthesis may occasionally be associated with bone diseases.

Diagnosis of spondylolisthesis is usually made from an X-ray exam of the spine which will show if a vertebra is out of place, and whether there are any fractures.

Most spondylo's don't progress further than the original forward slippage. To be sure that the fracture is not still active in a young person, which would allow further slippage, an MRI or Bone Scan may need to be performed.





Grades of Lumbar Spondylolisthesis

Spondylolisthesis can be described according to its degree of severity. One commonly used description grades spondylolisthesis with grade 1 being least advanced, and grade 5 being most advanced.

The spondylolisthesis is graded by measuring how much of the vertebral body has slipped forward over the body beneath it.

• Grade 1 is 0–25% forward slippage

• Grade 2 is 25–50%

• Grade 3 is 50–75%

• Grade 4 is 75–100%

• Grade 5 is when the vertebral body slips completely off the one below it (spondyloptosis)

Prognosis of Spondylolisthesis

The outlook for patients with lumbar spondylolisthesis is good. Most people with spondylolisthesis respond well to conservative treatment, without the need for surgery.

Patients who fail to improve with conservative treatment may be a candidate for surgery..

For complete information on the best treatment options for lumbar spondylolisthesis click here

Prevention of Spondylolisthesis

People with excessive forward curvature of the lower back ( lordosis) should avoid back hyperextension (bending backwards), weight lifting, and contact sports.

Lower back pain, although common in preadolescent and adolescent children, should be evaluated by a chiropractor or medical doctor, especially if there is excessive forward curvature of the lower back.

Complications of Spondylolisthesis

• Chronic back pain

• Nerve compression

• Temporary or permanent damage of spinal nerve roots, which may cause sensation changes, weakness, or paralysis of the legs

When to contact a doctor

Call your health care provider if:

• Your back appears to curve excessively

• You have severe or unresolved back pain or stiffness

• You have pain in your thighs and buttocks

To Your Best Health,

Dr. Cliff

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