Spondylolisthesis

A very common cause of low back pain, spondylolisthesis (spon-dee-low-lye-sis) occurs when there is stress fracture in one of the vertebrae, most typically in the lower back (lumbar) area. The fracture weakens the bone, causing it to shift out of place. If it shifts too far, the bone starts pressing on nerves. It occurs most frequently in teenaged athletes.

What causes Spondylolisthesis?

Although no one is sure what causes it, theories range from genetic propensity to repetitive stress to the lower back due to overuse.

How is Spondylolisthesis diagnosed?

X-rays of the lower back (lumbar) spine will show the position of the vertebra.

If the vertebra is pressing on nerves, a CT scan or MRI may be needed before treatment begins to further assess the abnormality.

How is Spondylolisthesis treated?

Non surgical treatment

Initial treatment for spondylolysis is always nonsurgical. The individual should take a break from the activities until symptoms go away, as they often do. Anti-inflammatory medications, such as ibuprofen, may help reduce back pain.

Occasionally, a back brace and physical therapy may be recommended. In most cases, activities can be resumed gradually and there will be few complications or recurrences. Stretching and strengthening exercises for the back and abdominal muscles can help prevent future recurrences of pain.

Periodic X-rays will show whether the vertebra is changing position.

Surgery may be needed if slippage progressively worsens or if back pain does not respond to nonsurgical treatment and begins to interfere with activities of daily living. A spinal fusion is performed between the lumbar vertebra and the sacrum. Sometimes, an internal brace of screws and rods is used to hold together the vertebra as the fusion heals.

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