Spondylolisthesis is a common condition of the lower back. It occurs when a lumbar vertebra (one of the bones that makes up the spine) slips over a vertebra beneath it, ending up on top of the lower vertebra.
Spondylolisthesis can occur at any age. Some blame its occurrence in children on participation in sports like gymnastics that put excessive mechanical strain on the lower back. However, while that certainly can play a part, spondylolisthesis in children is commonly due to a birth defect which increases in effect as the child ages, due to normal wear and tear.
Spondylolisthesis can be due to mechanical damage to the joint or the vertebra itself, such as that caused by injury. It is also commonly caused by arthritis. It occurs more often in older women than in older men, possibly due to structural differences in their backs.
Spondylolisthesis is commonly broken down into “grades.” These grades are distinguished based upon the percentage of the lower vertebra that is covered by the slipped vertebra.
Since Spondylolisthesis commonly occurs in the lower back, its usual symptoms are similar to those of lower back pain and sciatica. It is important to note, however, that not everyone with Spondylolisthesis experiences symptoms.
Those who do experience symptoms commonly feel pain in the lower back, sometimes radiating down into the buttock and the thigh. The location of the slipped vertebra may be sensitive to the touch.
If the slipped vertebra is putting pressure on the spinal cord, nerve-related symptoms such as numbness and leg weakness may be experienced as well.
Spondylolisthesis sufferers can sometimes be spotted due to the excessive lordosis (curvature) of the lumbar spine. This curvature typically causes the buttocks to protrude unnaturally.
One way to check for lordosis in children is by having the patient lie down – if lordosis is present, the back will not flatten against a hard, flat surface – in other words, an empty space will be present at the curve of the back.
Then, see if the patient can straighten his back against the surface, or if the lordotic curve is flexible enough that it straightens out when he bends forward – if so, the lordosis is less likely to predict a major concern.
Treatment for Spondylolisthesis is dependent upon the Grade of the disease, and the symptoms experienced.
In Grade 1 Spondylolisthesis, the upper vertebra covers between zero and twenty-five percent of the lower vertebra. In Grade 2, it’s between twenty-five and fifty, and so on, until Grade 5, or Spondyloptosis, at one-hundred percent. At one-hundred percent, the vertebra has slipped completely over and off of the vertebra beneath it.
Commonly physical therapy is prescribed for Spondylolisthesis patients, to strength the back muscles that support the spine.
Some Spondylolisthesis sufferers are simply instructed to take NSAIDs as needed and avoid positions that put excessive pressure upon the lower back. On the far opposite end of the spectrum are those who, with higher grade Spondylolisthesis, if resistant to all other measures of therapy, go under back surgery.