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Spondylolisthesis
What is Spondylolisthesis?
Spondylolisthesis in Minnesota refers to a condition in which one vertebra slips or shifts out of place relative to another vertebra. The term comes from the Greek words spondyl, meaning “whorl,” and olisthesis, meaning “to slip, slide, or fall.” Simply put, spondylolisthesis is the displacement, slippage, or subluxation of a vertebra.
The spinal column is made up of flat, ring-shaped bones called vertebrae. These vertebrae are stacked together and connected by supporting structures, including the intervertebral discs located between them.
When a vertebra becomes misaligned, it may compress spinal nerves, causing pain known as radiculopathy. In some cases, the displaced vertebra may place pressure on the spinal cord itself, resulting in pain and neurologic dysfunction called myelopathy.
Spondylolisthesis can occur in the cervical spine, typically at the third and fourth cervical vertebrae or the fourth and fifth cervical vertebrae. Vertebral displacement may also occur in the thoracic spine, although it is most commonly found in the lumbar spine, particularly between the fourth and fifth lumbar vertebrae.
In many cases, spondylolisthesis in Minnesota is preceded by spondylosis, which refers to age-related degeneration of the spine. The term spondylosis is often used interchangeably with osteoarthritis of the spine.
What Are the Symptoms of Spondylolisthesis?
Spondylolisthesis in Minnesota can cause significant back pain, particularly radiculopathy. However, symptoms vary depending on the location of the displaced vertebra, and not all patients experience the same symptoms.
Common symptoms include:
- Pain radiating down the leg (sciatic pain)
- Numbness or weakness in an arm or leg
- Pain that gradually worsens throughout the day
- Leg pain that shifts from side to side
- Cold feet
- Altered gait or pain while walking
- Reduced coordination and more frequent falls
Cervical Spondylolisthesis Symptoms
Patients with cervical spondylolisthesis often experience focal neck pain that worsens when the neck bends forward or backward. “Focal” pain means the discomfort is concentrated in a specific location rather than spread throughout a broader area.
Lumbar Spondylolisthesis Symptoms
Patients with lumbar spondylolisthesis in Minnesota commonly report focal lower back pain. In some cases, pain improves while lying down because that position stabilizes the spine.
A displaced lumbar vertebra may also lead to:
- Sciatic pain in the buttocks or legs
- Weakness in the legs
- Difficulty walking
- Increased pain while walking
What Causes Spondylolisthesis?
There are several different forms and causes of spondylolisthesis in Minnesota.
- Pathologic Spondylolisthesis: Noncancerous bony tumors can weaken a portion of the vertebra known as the pars interarticularis. The pars is part of the bony ring surrounding the spinal cord. When weakened bone fractures, the vertebra may become unstable and begin to slip.
- Dysplastic Spondylolisthesis: Dysplastic spondylolisthesis is a congenital condition in which the facet joints and surrounding spinal structures develop abnormally.
- Isthmic Spondylolisthesis: Isthmic spondylolisthesis commonly develops in children and adolescents because of a defect in the pars interarticularis, such as a poorly healed fracture. Over time, this defect can allow the vertebra to slip forward.
- Degenerative: Spondylolisthesis is often preceded by spondylosis. This condition is characterized by degenerative changes that make a portion of the spine unstable: degeneration of the disc and facet joints, calcification of surrounding ligaments, or spinal stenosis (narrowing of the spinal canal). Degenerative spondylolisthesis is the most common form that we treat at Inspired Spine.
- Traumatic Injury: A significant impact or traumatic injury can suddenly force vertebrae out of alignment, causing spondylolisthesis. Falls and motor vehicle accidents are common causes, although any severe trauma may contribute to this condition.
Conservative Spondylolisthesis Treatments
If you have spondylolisthesis in Minnesota without symptoms, treatment may not be necessary.
However, if spinal cord compression progresses and causes pain, weakness, or neurologic dysfunction, treatment may become necessary. Myelopathy associated with spondylolisthesis generally does not resolve on its own, and surgical treatment may eventually be required to relieve symptoms.
Nonsurgical Spondylolisthesis Treatments
When spondylolisthesis in Minnesota causes pain or difficulty walking, physicians typically begin with conservative treatment options before considering surgery.
Conservative therapies may include:
- Cervical collars
- Traction
- Physical therapy
- Spinal injections
Many physicians use a four-part approach to early management.
Anti-Inflammatory Medication
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as naproxen (Aleve) and ibuprofen (Advil), are commonly used to relieve pain associated with spondylolisthesis. In some patients, these medications may be more effective than muscle relaxants, opioid medications, or short-term oral corticosteroids.
Aerobic Fitness
Aerobic physical activity promotes blood flow to areas of nerve compression in the spine and strengthens muscles and other supporting structures. Walking, swimming, and use of an elliptical machine are suitable aerobic conditioning activities, but the use of a stationary bicycle is especially useful for patients with spondylolisthesis in Minnesota.
Look for a bike in which the pedals are more or less below the seat (like on a real bicycle), rather than choosing a recumbent bike in which the pedals are out in front of you. A more traditional configuration of the seat, pedals, and handlebars shifts your weight toward your upper body. In contrast, a recumbent bike directs your body weight toward the seat, thereby putting pressure on your lumbar spine.
Weight Loss
For patients who are overweight or obese, weight loss may help reduce spinal stress and improve symptoms. The less weight the spine must support, the less strain it experiences.
Although results vary from person to person, weight loss may provide additional health benefits beyond improving spinal conditions.
Management of Osteoporosis
Osteoporosis weakens bones and increases the risk of fractures and spinal instability. To help prevent progression of spondylolisthesis in Minnesota, physicians may monitor bone density carefully to ensure the spinal bones remain as strong and healthy as possible.
Inspired Spine is Minnesota’s leading spine center and a comprehensive spine care provider focused on relieving chronic back pain using the least invasive treatment options possible.
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