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Spondylolisthesis

(Slipped Vertebra)

Definition

The spine is made of several bones called vertebra. They are lined up so the spinal cord can run through the center of the bones. Spondylolisthesis is when one of the vertebrae (usualyy in the lower back area) slips out of place. It moves forward compared to the vertebra below and develops slowly over time.
Spondylolisthesis
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Causes

Spondylolisthesis is most often caused by a stress fracture. The fracture can make the vertebra unstable and allow it to slip forward. This type of fracture often occurs when a lot of stress and pressure is put on the back. This can occur with certain sports activities.
The condition can also be caused by spinal problems that are present at birth, like spina bifida.

Risk Factors

Factors that may increase your risk of spondylolisthesis include:
  • Rapid growth
  • Being an athlete, especially gymnasts, weight-lifters, and football players
  • Family history

Symptoms

Spondylolisthesis begins to progress at age 10-15 years. Symptoms may not appear until adulthood. In many cases of spondylolisthesis, there are no obvious symptoms. Symptoms that may be present include:
  • Low back pain, which may feel like muscle strain
  • Stiff back
  • Muscle spasms of the hamstring
  • Buttock pain and spasm
  • Changes in posture and/or gait
  • Numbness, weakness, or tingling around the pelvis, buttochs, or thighs
  • Loss of bladder control

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. Images of the spine will be taken with:

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include:

Physical Therapy

Physical therapy usually involves exercise. The exercise will focus on strengthening the abdominal and back muscles. A back brace may also be recommended.
If you are overweight, your doctor may recommend you lose weight.

Medications

Pain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), may help manage pain.

Surgery

Surgery may be needed if the bone has severly slipped or you do not respond to treatment. Surgery will fuse two of the vertebra together. The procedure is called spinal fusion.

Prevention

Take the following steps to help protect your spine:
  • Exercise regularly.
  • Get plenty of rest between workouts.
  • Take measures to protect your back when participating in sports.
  • Maintain a healthy weight.

RESOURCES

American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org

North American Spine Society http://www.spine.org

CANADIAN RESOURCES

Canadian Orthopaedic Association http://www.coa-aco.org

Canadian Orthopaedic Foundation http://www.canorth.org

References

Spondylolysis and spondylolisthesis. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/fact/thr%5Freport.cfm?Thread%5FID=155&topcategory=Spine. Accessed December 28, 2012.

Spondylolisthesis. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated September 6, 2012. Accessed December 28, 2012.

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