Spondylolisthesis
A condition in which an upper vertebra slips forward over the one below.
When the disc, joint capsule, ligaments and spinal muscles that connect the vertebrae weaken and degenerate, the segments separate and slip forward.
Common causes
01
Degeneration of discs and joints with age
02
Vertebrae weakened by a malignant tumor
03
Fracture of the vertebral joint process from trauma such as traffic accidents or falls
Signs to watch for
- Back pain when standing up from sitting or bending backward
- Pain in the back, buttocks or below the knee after standing or walking a lot
- Numbness, pain or pulling in the buttocks, thighs, calves or toes
How we diagnose
X-ray
The basic first test. Further tests may be added for a definite diagnosis.
MRI
Shows soft tissue that X-ray cannot, such as muscles, ligaments, discs, cartilage, nerves and blood vessels.
How we treat it
If symptoms are mild, a range of conservative treatments can help. If the slip is small, we monitor progress with non-surgical treatment.
Nerve block (non-surgical)
A mix of medications, such as a steroid, local anesthetic, and anti-adhesion agents, is delivered through a long needle deep to the painful nerve. This removes adhesions and calms inflammation, relieving pain and helping prevent recurrence. It is done while watching a live monitor, so the medicine reaches the exact source of pain.
Balloon decompression
A balloon widens the narrowed area. An enzyme that dissolves adhesions between the narrowed area and the nerve, and an anti-inflammatory that reduces swelling, are then delivered for a stronger effect.
Microscopic spine surgery
The most widely used spine surgery, keeping incisions minimal and preserving healthy tissue. A microscope magnifies the area up to 15 times to remove the herniated disc or thickened ligament.
When surgery is consideredSurgery is recommended when symptoms are severe and pain cannot be controlled with conservative treatment.