Spondylolisthesis

Spondylolisthesis

Spondylolisthesis is the slippage of one vertebral body out of position over another. It most frequently occurs in the lower back, where the spinal anatomy is subjected to a great deal of stress related to years of movement and the near-constant strain of supporting upper body weight. Vertebral slippage can take place anywhere in the spine and at any age, but it is a common cause of lower back pain in teenagers.

Classification

Vertebral slippage is graded I-IV, based on severity of the displacement. Grade I represents slippage of 25 percent or less; Grade IV represents slippage of 76-100 percent. In general, the greater the slippage, the more likely spondylolisthesis is to produce symptoms such as focal back or neck pain, radiating pain, tingling, numbness, muscle weakness, and a reduction in spinal mobility. The more displaced a vertebra is, the more vulnerable the spinal cord and adjacent nerve roots become to compression.

There are several classifications of spondylolisthesis, based on the underlying causes and characteristics of the condition:

• Degenerative lumbar – occurs in the lower back; the most common site for
vertebral slippage
• Degenerative cervical – occurs in the neck or upper back; extremely rare and
commonly misdiagnosed
• Congenital – present at birth; can manifest itself during adolescence and is among
the most common back pain causes for teenagers
• Isthmic – occurs as a result of spinal fracture; could be traumatic injury or a result
of repetitive stressSciatica
• Retrospondylolisthesis – backward (posterior) slippage of a vertebral body

Treatment

Treatment is geared toward alleviating symptoms caused by the displacement of one or more vertebrae. Conservative methods such as pain medication, physical therapy, exercise, stretching, corticosteroid injections, and other techniques generally are sufficient for symptom management. However, vertebral slippage caused by traumatic injury or a severe congenital condition such as scoliosis may require surgery. Surgery may also become an option in patients whose symptoms do not respond well to several weeks or months of conservative treatment.

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