Spondylolisthesis

The word spondylolisthesis derives from two parts. spondylo which means spine and listhesis which means slippage. Spondylolistheis is the condition in which there is a slippage of one vertebra over the other.

Causes

Spondylolisthesis is a forward slip of one vertebra relative to another. It can be congenital (since birth) or develop in adolescence or in adults. The disorder may result from the physical stresses to the spine from physical activity, trauma or general wear and tear.
There are two common types of spondylolisthesis, degenerative and lytic. Degenerative spondylolisthesis occurs in older patients and is caused by the wear and tear of the disc and facet joints. There is no tear in the lamina (part of the vertebra at the back). The spinal canal narrows down squeezing the nerves, leading to increased leg pain or weakness on walking which is eased when leaning forward or sitting down. Patients suffering from degenerative spondylolisthesis also complain that although they cannot walk straight, they find their pain relieved by leaning forward such as over a shopping trolley or cycling.
In lytic spondylolisthesis, there is a break in the lamina and one vertebra slips forwards on the other. The spinal canal is usually not narrowed down, but the nerves can be squeezed causing leg pain and difficulty walking.

Common Symptoms

Many people with spondylolisthesis will have no symptoms, and only become aware that there is a problem when it is revealed on an x-ray for a separate problem.

Symptomatic patients present with pain in the low back, particularly after exercise, increased lumbar lordosis. The pain may radiate to the lower limbs associated with/ without weakness in one or both thighs or legs and reduced ability to control bowel and bladder functions.

In cases of advanced spondylolisthesis changes may occur in the way people stand and walk; for example, development of a waddling style of walking. This causes the abdomen to protrude further, due to the low back curving forward, the chest may seem shorter and muscle spasms in the low back may occur.

 

 

Treatment

Conservative: Patients presenting with mild, on and off pain can be considered for conservative management. These include analgesics and anti-inflammatory medications. Conservative management also includes physiotherapy exercises which include isotonic and isometric exercises and muscle stretches. Low impact exercises like swimming, walking and jogging help to develop good aerobic fitness. 

Surgical: Patients with severe pain in the back along with lower limb radiculopathy are candidates for surgery. The primary determining factors for surgery are pain leading to restricted lifestyle and failure of conservative management. Surgery helps to gets rid of the pain but in long term patients, lifestyle modifications are necessary so as to prevent the recurrence of the disease. Surgery for spondylolisthesis does not lead to paralysis. The surgical treatment delayed for long period affects the outcome of surgery. 
The surgical treatment consists of putting screws and rods in the bone to prevent further slip of the vertebral bodies and compression on the nerves. The surgery is done via endoscopic methods. All the patients are allowed to walk on the same day of surgery after 6 hours. The patient is discharged 4 days after the surgery. The patient is allowed to walk as much as per his comfort.

How to prevent spinal stenosis:

We at Shanta spine institute believes in prevention is better than cure, so we keep our main emphasis on prevention of the disease more than the treatment. The main cause of spondylolisthesis is aging process and unhealthy lifestyle. So we aim to prevent the disease by certain lifestyle modifications which had to be followed regularly. This includes daily 1 hour of exercise, healthy diet which includes lots of fruits and salads, 4-5 litres of water daily and to maintain weight which is normal according to your height and age. The exercise program like swimming, yoga, walking jogging etc helps to develop core strength and allows us to maintain strength and flexibility of the spine. Lifestyle modifications such as quitting tobacco chewing, smoking cigarette and alcohol is also very important.

Conservative: Patients presenting with mild, on and off pain can be considered for conservative management. These include analgesics and anti-inflammatory medications. Conservative management also includes physiotherapy exercises which include isotonic and isometric exercises and muscle stretches. Low impact exercises like swimming, walking and jogging help to develop good aerobic fitness. 

Surgical: Patients with severe pain in the back along with lower limb radiculopathy are candidates for surgery. The primary determining factors for surgery are pain leading to restricted lifestyle and failure of conservative management. Surgery helps to gets rid of the pain but in long term patients, lifestyle modifications are necessary so as to prevent the recurrence of the disease. Surgery for spondylolisthesis does not lead to paralysis. The surgical treatment delayed for long period affects the outcome of surgery.
The surgical treatment consists of putting screws and rods in the bone to prevent further slip of the vertebral bodies and compression on the nerves. The surgery is done via endoscopic methods. All the patients are allowed to walk on the same day of surgery after 6 hours. The patient is discharged 4 days after the surgery. The patient is allowed to walk as much as per his comfort.

How to prevent spinal stenosis:

We at Shanta spine institute believes in prevention is better than cure, so we keep our main emphasis on prevention of the disease more than the treatment. The main cause of spondylolisthesis is aging process and unhealthy lifestyle. So we aim to prevent the disease by certain lifestyle modifications which had to be followed regularly. This includes daily 1 hour of exercise, healthy diet which includes lots of fruits and salads, 4-5 litres of water daily and to maintain weight which is normal according to your height and age. The exercise program like swimming, yoga, walking jogging etc helps to develop core strength and allows us to maintain strength and flexibility of the spine. Lifestyle modifications such as quitting tobacco chewing, smoking cigarette and alcohol is also very important.

 

 

 

 

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