Spondylolisthesis is a condition where a vertebra (typically the 5th lumbar vertebra) slips out of place onto the vertebra below causing misalignment and narrowing of the spinal column. This places pressure on the spinal nerves resulting in pain in the back, buttocks, and/or legs when walking or standing. As the spine tries to stabilize itself, the joints between the slipped vertebra and adjacent vertebrae can become enlarged and pinch nerves.
Spondylolisthesis presents as pain in the lower back, legs, or buttocks, a feeling of “electrical shock” which travels down the legs, numbness or tingling in the lower extremities or weakness in the leg muscles.
Spondylolisthesis can be congenital (present at birth) or develop at any point in life. It is believed that some individuals are born with a genetic predisposition to developing spondylolisthesis but the condition can also occur as a result of physical overuse or trauma.
If spondylolisthesis is suspected, x-rays would be ordered to assess the alignment of the spine and the position of the vertebrae. If spinal/vertebral issues are found, CT and MRI scans would then be ordered to obtain details about the severity of the condition and develop a course of treatment.
Conservative treatment options for spondylolisthesis include:
- Activity restrictions such as avoiding lifting or bending
- Physiotherapy for range of motion and core strengthening
- Anti-inflammatory medications
- Epidural injections
Severe spondylolisthesis can be treated with a decompressive laminectomy. This is a surgical procedure where the section of the vertebra (typically the lamina) and tissue that are placing pressure on the nerves are removed. However, this makes the spine unstable so a spinal fusion would also be performed to hold the adjacent vertebrae in place and proper alignment.