Many people with a spondylolisthesis have minimal to no symptoms and only become aware after an x-ray is performed. Depending on the severity of the spondylolisthesis, it can produce symptoms such as neck or back pain after exercise, or pain and weakness in thighs and down legs when walking any distance. Hamstrings can feel tight in musculature, decreasing flexibility, and the patient may have increased lordosis (swayback). In more severe cases, patients may have nerve root pinching leading to reduced ability to control bowel and bladder functions.
There are several classifications of Spondylolisthesis. Vertebral slippage is graded into 4 levels based on severity of the displacement. Grade I being the least advanced with slippage of 25% or less to a Grade IV being most advanced of 76- 100%. Various types of Spondylolisthesis can be characterized as follows:
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 among the most common back pain causes for teenagers
ISTHMIC – result of spinal fracture; could be traumatic injury or result of repetitive stress sciatica
RETROSPONDYLOLISTHESIS – backward (posterior) slippage of a vertebral body.
Treatment is geared toward alleviating symptoms caused by the displacement of one or more vertebrae. Conservative methods such as medication, modified activities, proper stretching and exercise as part of a physical therapy program, Chiropractic manipulation mobilizing painful joint dysfunction, injections to assist with pain during increase joint function, 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.
Spondylolisthesis is the slippage of one vertebral body forward out of position over another. Vertebral slippage can take place anywhere in the spine and at any age although most common in the lumbar region. It is the most noticeable in younger people due to physical activities, such as weightlifting, gymnastics, or football, or older people that have fallen off elevated areas and landed on their feet, or have heavy-load demanding jobs. Vertebral slippage is graded into 4 levels based on severity of the displacement. Grade I represents slippage of 25% or less to a Grade IV of 76-100%.
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