Spondylolisthesis
Spondylolisthesis is a condition where a vertebra slips forward over another vertebra. Many people who have this are often symptom free, however when it is symptomatic and it can cause pain and radicular symptoms. It most commonly occurs in the lumbar spine (lower back) and at the L5-S1 vertebrae.
Symptoms:
Low back pain
Back stiffness
Buttock pain
Difficulty walking
Tightness in hamstrings
Numbness, weakness, or tingling (more common in higher grades of a spondylolisthesis)
There are several causes of spondylolisthesis. The most common type is degenerative, which occurs mostly in adults.
Causes
Congenital: A vertebra is defective from the time a person is born
Isthmic: This is caused by another condition called spondylolysis. A spondylolysis is a fracture in the part of a vertebra can result in the vertebra slipping
Degenerative: Over time, the disks that cushion vertebrae dry out and get thinner. This thinning makes it easier for a vertebra to slip out of place
Traumatic: An injury or trauma causes a vertebra to slip out of place
Pathological: Another condition such as osteoporosis or cancer causes it
Post-surgical: A vertebra slips out of place after spinal surgery
Spondylolisthesis is graded by the amount of slippage. The majority of cases are typically Grade I.
Grades
Grade I: Up to 25% slippage
Grade II: Up to 50% slippage
Grade III: Up to 75% slippage
Grade IV: 76-100% slippage.
Grade V: More than 100% slippage (also known as spondyloptosis)
How do I know if I have a spondylolisthesis?
A physical examination performed by a physician as well as imaging such as an X-ray will help determine if there is a spondylolisthesis.
Treatments
Lower grades of spondylolisthesis is often treated conservatively by strengthening of supportive back muscles through physical therapy. Treatment may also include:
Rest
Anti-inflammatory medicines
Steroid shots
Bracing
Treatment for spondylisthesis is typically sucessful and the majority of patients with spondylolisthesis are symptom free after treatment.
Check out the video below for a few exercises to treat spondylolisthesis:
Bird dog (1:18 in video)
Lunge with trunk rotation (2:16 in video)
Deep squat hold (3:44 in video)
Written by Daniel Le, DPT