Spondylolisthesis (“spon-DY-lo-lis-THEE-sis”) is a spinal condition in which one of the bones that makes up the spine (the vertebrae) slips forward and moves out of place. This misalignment of the spine can cause chronic low back pain, disability, and it can get progressively worse. Most people who acquire this condition were either born with it or it occurs from trauma, sports injury, or certain disesases like spondylosis, cancer or osteoporosis.
To ensure the condition doesn’t progress, your doctor will take periodic spinal X-rays to monitor the affected vertebra. Usually, the risk of the vertebra slipping so far forward that it compresses nearby nerves is highest in children and adolescents, whose spines are still growing. Adults whose spondylolisthesis progresses usually have degenerative spinal conditions such as spinal osteoarthritis or disc disease that damages the spine’s joints and discs, which causes the vertebrae to destabilize.
Unless the spondylolisthesis has progressed to where the symptoms are unmanageable, most orthopedic physicians treat it with conservative, nonsurgical methods. The American Academy of Orthopaedic Surgeons recommends trying nonsurgical treatments first. Spondylolisthesis is often treated through prescribed physical therapy, bracing, activity modification, and over-the-counter pain relief medicine to relieve discomfort and improve function. Physical therapy is useful for patients with spondylolisthesis, as it teaches patients how to strengthen their core muscles to reduce the amount of stress the spine absorbs. A physical therapist can also evaluate the patient’s progress to determine whether more aggressive treatment is required.
While nonsurgical treatment is usually successful, some patients do not respond well to it and require surgery to relieve their symptoms and prevent the condition from worsening. Surgery may be necessary if the patient’s vertebra has slipped so far forward that their posture looks deformed or if their condition continues to progress despite nonsurgical treatment. The goal of surgery to treat spondylolisthesis is to eliminate pain and relieve the pressure from a pinched nerve. Surgical treatments used to correct spondylolisthesis include Pars repair, spinal decompression, or spinal fusion.
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