Spondylolisthesis
What is Spondylolisthesis?
Daily life can take its toll on a healthy spine. This becomes especially apparent as we age and the skeletal components that reinforce our spine begin to deteriorate. Spondylolisthesis—a common complication of spinal degeneration—occurs when an unprotected vertebra slips painfully forward over the vertebra that lies beneath it.
Degenerative Disc Disease is a major contributor to spondylolisthesis. As we age, our intervertebral discs—the rubbery pads which defend our spinal vertebrae against vertical and horizontal forces known as compression and shear—begin to dehydrate. As our intervertebral discs lose their gelatinous content and become more brittle with age, our likelihood of sustaining an accidental injury to the spine skyrockets. A dislocated vertebra (spondylolisthesis) or a ruptured disc (herniation) is often the undesirable outcome.
The aging process can also weaken the hinge-like facet joints that support our spinal vertebrae on the backside of our spine. Breakdown of these joints promotes excess forward flexion of the spine, advancing the progression of osteoarthritis and leaving our spine vulnerable to spondylolisthesis. We normally think of spinal flexibility as a good thing; however, the spine requires a certain amount of rigidity in order to maintain its structural integrity. An unaligned vertebra can place pressure on neighboring nerves and result in symptoms of excruciating discomfort and muscular weakness.
In addition, there are many different kinds of spondylolisthesis—not all of which are the result of aging. For example, the condition may be congenital (or present at birth) as in Dysplastic Spondylolisthesis; or, the disorder may result from a traumatic blow to the spine as in Traumatic Spondylolisthesis. However, the two most common types of spondylolisthesis are:
- Degenerative Spondylolisthesis: This type of spondylolisthesis occurs when the skeletal and cartilaginous components that support our spinal vertebrae lose their capacity to maintain proper alignment of the spine. Spinal degeneration, the process that leads to this form of spondylolisthesis, can result from a number of factors: Degenerative Disc Disease, Facet Joint Osteoarthritis, etc.
- Isthmic Spondylolisthesis: This form of spondylolisthesis develops from a fracture in the pars interarticularis—a tiny sliver of bone that resides on the backside of the spine where the vertebrae that form the facet joints connect. This form of spondylolisthesis is most common in younger people, with athletes such as gymnasts, football players, and weightlifters being the most affected.
Are you in need of a qualified specialist, who has earned an outstanding reputation for delivering spondylolisthesis relief? Our board certified orthopedic specialist, Dr. Frazier, has been twice awarded the title of “New York Super Doctor” by the New York Times Magazine for his expertise and dedication to providing minimally invasive spine care.
What are the Symptoms of Spondylolisthesis?
Although spondylolisthesis can occur at any level of the spine, it is most common in the weight-bearing region of the lower back (the lumbar spine). Since spondylolisthesis often involves the degradation of more than one skeletal component, the symptoms can range from virtually absent to debilitating. Common symptoms may include:
- Back Pain: Localized pain in the lower back at the site of vertebral slippage
- Sciatica: Warm, piercing pain that radiates from the sciatic nerve in the lumbar spine and down through the buttocks, posterior thigh, calves, and/or feet
- Cervical Radiculopathy: White-hot, electric pain that erupts from the site of nerve compression in the cervical spine (neck) and diffuses through the shoulders, arms, hands, and/or fingers
- Tingling: Numbness or prickling in the upper or lower limbs
- Stiff Hamstrings: Increased tightness in the hamstrings or gradual weakening of the leg muscles
- Activity-Related Pain: Pain that worsens while standing or with exertion
- Swayback: Development of swayback (or lordosis) that may interfere with your gait or render walking extremely painful
- Emergency Symptoms: Seek immediate medical attention if your spondylolisthesis symptoms include: sudden, crippling pain, difficulty controlling your bowel or bladder, fever, or sensations of numbness in the saddle region of the buttocks or groin.
Worried that your symptoms of neck or back pain could be the result of spondylolisthesis? Dr. Frazier, our Harvard-trained orthopedic expert, has nearly 20 years of experience in delivering award-winning spine care!
What are the Treatments for Spondylolisthesis?
Spondylolisthesis is a fairly common condition – so common in fact that some people never even realize that they have it! A slipped vertebra may go undetected until a neighboring nerve is irritated, shooting telltale signals of pain into the arms or legs. In mild to moderate cases of spondylolisthesis, the following non-surgical remedies are recommended: Rest, immobilization, or heat & ice application to the injured area; pain or anti-inflammatory medications; physical therapy or chiropractic care; and steroidal injections to provide pain relief at the site of spondylolisthesis.
Non-surgical treatment options can permit patients to return to their lives with dramatically reduced pain. However, when nonoperative treatments fail to produce satisfactory results, our board certified surgeon, Dr. Frazier, strives to connect his patients with minimally invasive treatment options. These may include:
- Lumbar Laminectomy: A lumbar laminectomy is an outpatient decompression procedure, in which your surgeon removes a tiny segment of the lamina—the backside portion of a degenerated vertebra. Extraction of the lamina allows for the decompression of pinched nerves. This procedure may be combined with a spinal fusion to reinforce the structural integrity of the lumbar spine.
- TLIF: A TLIF (Transforaminal Lumbar Discectomy with Interbody Fusion) is a minimally invasive surgical solution, in which your surgeon performs the entire procedure through a tiny tube that allows for access to the spine. During this procedure, your surgeon removes the problematic intervertebral disc and uses a bone graft to fuse together the remaining gap.
- Minimally Invasive Spinal Fusion: Severe cases of spondylolisthesis may require a spinal fusion procedure—a sophisticated surgical technique that uses a bone graft to fuse together two adjacent vertebral bodies. The minimally invasive version of this technique offers the permanent stability of a traditional fusion procedure while enhancing postoperative outcomes and minimizing unnecessary tissue destruction.
If you’ve been living with spondylolisthesis pain, you want the reassurance that your recovery is in good hands. Dr. Frazier—internationally recognized spine surgeon and surgical technology consultant—has been redefining relief for nearly 20 years!
Meet Dr. Daveed Frazier
Dr. Frazier is a Harvard-trained, board certified orthopedic spine surgeon. He’s held an academic appointment at Columbia University College of Physicians and Surgeons and New York’s SUNY Downstate. Dr. Frazier is also a respected lecturer, accomplished researcher, published author on spine disorders and treatment, and a consultant for several international spine companies.
After completing his undergraduate education at Brown University, Dr. Frazier attended Harvard Medical School, where he graduated cum laude. He completed a Harvard internship based at the New England Deaconess Hospital in Boston, MA, followed by a Harvard combined residency before becoming chief resident at Massachusetts General Hospital.