Spondylolisthesis
occurs when one vertebra slips forward in relation to an
adjacent vertebra, usually in the lumbar spine. The symptoms
that accompany a spondylolisthesis include pain in the low
back, thighs, and/or legs, muscle spasms, weakness, and/or
tight hamstring muscles. Some people are symptom free and
find the disorder exists when revealed on an x-ray. In advanced
cases, the patient may appear swayback with a protruding
abdomen, exhibit a shortened torso, and present with a waddling
gait.
Spondylolisthesis
can be congenital (present at birth) or develop during childhood
or later in life. The disorder may result from the physical
stresses to the spine from carrying heavy things, weightlifting,
football, gymnastics, trauma, and general wear and tear.
As the vertebral components degenerate the spine's integrity
is compromised.
Another type
of spondylolisthesis is degenerative spondylolisthesis,
occurring usually after age 50. This may create a narrowing
of the spinal canal (spinal stenosis).
The movie below
shows how the upper vertebrae can slip forward on the lower
vertebrae and cause pinching of the spinal nerves due to
a Pars defect at L5.
Diagnosis:
A routine lateral (side) radiograph taken while standing
confirms a diagnosis of a spondylolisthesis. The x-ray will
show the translation (slip) of one vertebra over the adjacent
level, usually the one below.
Using
the lateral (side) x-ray, the slip is graded according to
its degree of severity. The Myerding grading system measures
the percentage of vertebral slip forward over the body beneath.
The
grades are as follows:
Grade 1: 25%
Grade 2: 25% to 49%
Grade 3: 50% to 74%
Grade 4: 75% to 99%
Grade 5: 100%*
*Complete vertebral
slippage, known as spondyloptosis.
Treatment:
If the spondylolisthesis is non-progressive, treatment with
physical therapy and spinal manipulation of restricted joints
above and below the segment with the slippage usually gives
tremendous relief to the patient. Lumbar flexion distraction
also provides a great relief from the stress. This is a
very stable condition in the vast majority of cases and
responds extremely well to treatment. Call us today at 408-739-2273
to set up an appointment.
