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Spondylolisthesis

Spondylolisthesis occurs when one vertebra slips forward in relation to an adjacent vertebra, usually in the lumbar spine. The symptoms that accompany a spondylolisthesis include pain in the low back, thighs, and/or legs, muscle spasms, weakness, and/or tight hamstring muscles. Some people are symptom free and find the disorder exists when revealed on an x-ray. In advanced cases, the patient may appear swayback with a protruding abdomen, exhibit a shortened torso, and present with a waddling gait.

Spondylolisthesis can be congenital (present at birth) or develop during childhood or later in life. The disorder may result from the physical stresses to the spine from carrying heavy things, weightlifting, football, gymnastics, trauma, and general wear and tear. As the vertebral components degenerate the spine's integrity is compromised.

Another type of spondylolisthesis is degenerative spondylolisthesis, occurring usually after age 50. This may create a narrowing of the spinal canal (spinal stenosis).

The movie below shows how the upper vertebrae can slip forward on the lower vertebrae and cause pinching of the spinal nerves due to a Pars defect at L5.

Diagnosis:

A routine lateral (side) radiograph taken while standing confirms a diagnosis of a spondylolisthesis. The x-ray will show the translation (slip) of one vertebra over the adjacent level, usually the one below.

Using the lateral (side) x-ray, the slip is graded according to its degree of severity. The Myerding grading system measures the percentage of vertebral slip forward over the body beneath.

The grades are as follows:

Grade 1: 25%
Grade 2: 25% to 49%
Grade 3: 50% to 74%
Grade 4: 75% to 99%
Grade 5: 100%*

*Complete vertebral slippage, known as spondyloptosis.

Treatment:

If the spondylolisthesis is non-progressive, treatment with physical therapy and spinal manipulation of restricted joints above and below the segment with the slippage usually gives tremendous relief to the patient. Lumbar flexion distraction also provides a great relief from the stress. This is a very stable condition in the vast majority of cases and responds extremely well to treatment. Call us today at 408-739-2273 to set up an appointment.