Is Spondylolisthesis causing my neck or back pain?
Is Spondylolisthesis causing my neck or back pain?
Spondylolisthesis Symptoms & Treatment Options
Spondylolisthesis is a condition that occurs when one vertebra in the spine slides forward over the vertebra that sits beneath it. This most commonly occurs in the lumbar region of the spine, or the lower back, because this spinal segment routinely participates in rotating the torso and lifting heaving objects. Although lumbar spondylolisthesis is most common, slippage can also occur in the cervical or thoracic spine.
The amount of vertebral slippage can occur at different grades or intensities. These degrees are typically broken into five grades based upon the severity of the movement: Grade 1 involves 25% forward slippage, or movement that’s a quarter of the way off the front edge of the lower vertebrae. Similarly, Grade 2 involves 50% forward slippage; Grade 3 involves 75% slippage; Grade 4 involves 100% slippage; and Grade 5 indicates that the vertebra has completely fallen off of the vertebra beneath it.
Symptoms of Spondylolisthesis
Spondylolisthesis can result in bone-on-bone contact and nerve or spinal cord compression, which can lead to anywhere from mild to debilitating symptoms. On the other end of the spectrum, individuals with spondylolisthesis may experience no symptoms at all, or their symptoms may show up years later. Sometimes, the only way to identify if one has spondylolisthesis is to accidentally discover it in an X-ray or MRI that was taken to assess another spinal condition. However, if you are experiencing any of the symptoms listed below, you may be exhibiting signs of spondylolisthesis:
- A dull or intense pain, especially in the lower back or neck depending upon location of the slip
- An increase in the visibility of lordosis or swayback
- Pain, weakness, tingling, or the loss of sensation in one or both of the arms or thighs
- Muscular tension in the hamstrings or lower back, with back spasms possible
- A change in the way that person stands or walks, such as developing a waddling gait
- Loss of control of the bladder or bowels. These symptoms require urgent attention.
If you are experiencing any of these symptoms, please contact the Advanced Spine Center to schedule an appointment. Dr. Jason E. Lowenstein, director of the spinal deformity center at Morristown Medical Center, specializes in treating conditions like spondylolisthesis. Recognized as a Top Doctor, Dr. Lowenstein will work with you to develop an individualized treatment plan that delivers long-term relief from spondylolisthesis.
Causes of Spondylolisthesis
There is not simply one cause of spondylolisthesis, but rather, five main reasons why vertebral slippage may occur. Types of spondylolisthesis include: congenital, isthmic, degenerative, traumatic, and pathologic.
Congenital spondylolisthesis is a condition that is present at birth and results in the deficiency of the vertebral facets. The facets are the joints connecting vertebrae that allow for spinal movements from side to side or forward and back. When these joints are incorrectly formed at birth, the facet joints are more prone to instability or fracture, which can cause spondylolisthesis.
Isthmic spondylolisthesis is only slightly less common, and involves a defect in the part of the vertebra called the isthmus, or pars interarticularis. These small pieces of bone connect the facet joints on the back side of our spine. The pars interarticularis is most prone to fracture in children between the ages of 5-7 years old, which often leads to pediatric spondylolisthesis.
Degenerative spondylolisthesis can occur as a result of the aging process as bones and spinal tissues lose their integrity over time. This degeneration is caused by the forces of gravity and the normal wear-and-tear that the spine accumulates over the years. Arthritis can play a factor in this degeneration. As our bones and tissues degrade, these degenerative processes lead to more chances for instability, friction, compression, and slippage.
Traumatic spondylolisthesis occurs when an accident or sudden force results in injury to the spine. Events such as car accidents, falls, and sports injuries can cause damage to spinal structures that may lead to vertebral slippage. Many athletes, even very young athletes, can experience spondylolisthesis because of the quick-pivoting movements associated with sports such as gymnastics and football.
And finally, pathologic spondylolisthesis involves a disease or condition that leads to degeneration of the vertebrae. This can include spinal tumors or rheumatoid arthritis, both of which can lead to the progressive deterioration of spinal structures and tissues.
Spondylolisthesis Treatment Options
In advanced grades, spondylolisthesis can lead to high levels of spinal instability. Spinal fusions involve the mechanical fastening of vertebrae into place. For some, this type of surgery may be required in order to restore spinal stability or eliminate painful symptoms.
Spondylolisthesis can also lead to spinal compression and damage to intervertebral discs or nerves. Along with a spinal fusion, your surgeon may perform a spinal decompression such as a laminectomy or foraminotomy to create additional room for the spinal cord and nerves.
Depending upon the degree of movement, pain can be a minor or major symptom of spondylolisthesis. For some, oral medications like acetaminophen and ibuprofen may be sufficient. For others, prescription strength painkillers may be necessary.
Not all treatments for spondylolisthesis are operative: physical therapists can teach exercises or stretches to ease symptoms; chiropractors can adjust painful joints; and exercise or yoga instructors can help with increasing your muscular strength and spinal flexibility.