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Spondylolisthesis

Spondylolisthesis is a forward slip of one vertebra relative to another caused by either degeneration (degenerative spondylolisthesis) or fracture to the lamina at the back of the spine (lytic spondylolisthesis) .

Risk factors for spondylolisthesis include a family history of back problems. Other risk factors include a history of repetitive trauma or hyperextension of the lower back or lumbar spine. Athletes such as gymnasts, weight lifters who have large forces applied to the spine during extension are at greater risk for developing spondylolisthesis.

Common Symptoms

  • Increased pain in the low back, particularly after exercise
  • Increased lordosis (i.e. swayback)
  • Pain and/or weakness in one or both thighs or legs

If the spinal canal is narrowed by the movements of the vertebra the nerves are squeezed, 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.

Treatments vary with the severity of the spondylolisthesis. Most patients only require physical therapy combined with some modifications to their lifestyles.

If the pain is coming from nerve root irritation, epidural steroid injections may be considered. For cases where pain is not responding to therapy, or the slip is very severe, surgery is a good option to consider. The surgery involves stabilizing the spine and freeing up the nerve roots – a decompression and fusion operation.

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