Spondylolysis and Spondylolisthesis: An Overview
Spondylolysis is a spine disorder characterized by a defect in one or both wing-shaped parts of a vertebrae. It often causes stress fractures in the vertebrae which can lead to spondylolisthesis, or the slipping of a vertebrae, typically at the base of the spine.
Anatomy
The human spine is made up of 24 vertebrae stacked on top of one another. These disks connect to protect the spinal cord. The first disk of the lower spine comprises the lumbar spine, which is where spondylolysis and spondylolisthesis are most common due to the added stress typical to this area of the spine. Between each vertebra is a facet joint, which is where the stress fractures characteristic of this spine disorder typically occur.
Causes
There are four main classifications of spondylolysis and why it causes spondylolisthesis. The first is dysplastic or congenital, meaning the spine disorder is present at birth. It can also be isthmic, meaning the spondylolisthesis stems from a stress fracture, or similarly it can be caused by physical trauma. This is especially common in those who participate in any athletic activity, especially in their adolescence. Activities that strain the spine such as gymnastics and weight lifting increase the risk. Lastly, there is degenerative spondylolysis, meaning the disks are being broken down by infection or disease.
Symptoms
While about five percent of the population has spondylolysis, only a tenth of these individuals will experience any symptoms of their condition. Many don’t even know they have the spine disorder or discover it years after it develops. The most common symptoms to develop are lower back pain, which will likely spread across the lower back and feel similar to a pulled muscle. This pain typically increases with physical activity. Shooting pain down the leg through the buttock is also common, due to the pressure that can feel like a pinched nerve. Severe slips can also cause numbness or tingling as the nerves are put under pressure. These symptoms often show themselves during pre-teen growth spurts.
Treatment
Non-surgical treatment for these conditions begin with rest and abdominal strengthening exercises administered by a physical therapist. Over-the-counter anti-inflammatory drugs such as ibuprofen can also be used to minimize pain. A brace to stabilize the spine and decrease movement is also common. If the spinal slip is more severe and non-surgical methods have not worked, surgery may be necessary. The procedure typically used for this is a spinal fusion, or lumbar fusion, where the vertebrae in the lumbar spine are essentially welded back together to allow the spine to heal on one piece. This is done by placing a bone graft between the vertebrae in question, and may also require metal screws or rods to increase stability. This procedure limits flexibility by eliminating motion between damaged vertebrae which decreases pain. Most patients are able to return to normal physical activity and exercise without pain after proper healing.
Spondylolisthesis caused by spondylolysis is unpleasant for many but it is highly treatable and often can be relieved without invasive surgery. Be sure to consult your doctor and take proper measures before making a decision about your spinal health.
