What is Spondylolisthesis?
The spine is made up of several bones called vertebrae, which sit upright on top of each other. Spondylolisthesis is a term used to describe a slip or shift out of position of one of your vertebrae. Since the spinal cord passes through the vertebral bones, it can be at risk of damage depending on the extent of the slip.
What causes Spondylolisthesis?
Spondylolisthesis can be caused by wear and tear at the back of the vertebra due to arthritis, or by a stress fracture, known as spondylolysis. It commonly occurs in the lower (lumbar) spine. Young people who take part in sports which involve overstretching of the lower back, such as weight lifting, gymnastics and rugby, are at greater risk, as are people born with thinner and weaker vertebral bones.
How is Spondylolisthesis diagnosed?
A spinal specialist will ask some questions about your pain and perform a careful assessment looking for the signs of spondylolisthesis, such as lower back pain and stiffness which gets worse with exercise. The pain may spread down your buttocks and the back of your legs, or lead to muscle spasms affecting the way you walk. Imaging such as x-rays, CT or MRI scans can help confirm the diagnosis.
Treatment and recovery
Non-surgical treatment is often effective at relieving your symptoms. It involves resting your lower back, taking anti-inflammatory medications, and physiotherapy. Recovery time can vary, but our spinal specialists and physiotherapists can advise you on slowly returning to your normal activities.
If these treatments are not effective, then surgery may be required. For minimal slips, fractures can be repaired with minor surgery using a screw and bone graft (an extra piece of bone or artificial bone).
More significant slippages will need surgery to realign the vertebrae and fuse them together using bone grafts, known as spinal fusion. The procedure may involve removing or replacing the disc (soft tissue) between your vertebral bones and the surgeon may remove excess tissue to relieve pressure on your spinal cord. After the operation, you will need to stay in hospital for up to 4 days while we help you to start walking again. Your wound will need to be checked at 2 weeks and a course of 6-12 weeks of physiotherapy will help speed your recovery. We aim for you to be enjoying your normal everyday life again by 3-6 months after the operation.