Spondylolisthesis

When a vertebra — a bone in your spine — is weakened or damaged by a fracture, deformity, aging or disease, it's more vulnerable to slipping. The vertebrae in your lower back are especially at risk of abnormal movement because this part of your back carries and absorbs most of your body's weight. Back-stressing motions such as twisting, turning and bending forward can add to the burden on your lower back, causing a vertebra to begin to slip — especially if it's already weakened. If the vertebra continues to slip, it may press on spinal nerves and cause pain.

Arthritis is the most common cause of spondylolisthesis in adults. In children and teens, spondylolisthesis is often due to a sudden trauma or a birth defect that weakens spinal bones. Rapid growth spurts during childhood can also cause vertebrae to slip.

Some people are born with thinner or irregular bones that are more vulnerable to slipping. If your mother or father has spondylolisthesis, you’re at greater risk of developing it.

Spondylolisthesis is also more common in athletes who participate in sports like football, weightlifting or gymnastics. These types of activities can stress the lower back, while also stretching, arching or overextending the spine. They may result in a stress fracture and unstable vertebrae, which increases the risk of spondylolisthesis.

Prevention

Although you can’t change some risk factors for spondylolisthesis, such as family history or age-related factors, you can take steps to improve the health of your spine:

• Ask your doctor about an exercise plan that's right for you. He or she may refer you to a physical therapist for a personalized exercise and stretching program.
• Maintain good posture when sitting or standing.
• Lift correctly and carefully, especially when moving heavy objects.
• Limit high-impact sports or other activities that stress your lower back, especially those that involve bending, twisting and lifting.
• Maintain a balanced, nutritional diet and stay physically fit, and maintain a healthful weight for you. Excess weight places added stress on your spine.
• If you smoke, quit, and avoid second-hand smoke.
• Stay well-rested and get a good night's sleep regularly.

Taking these steps not only helps you avoid back problems, it can improve your overall health and well-being. El Camino Health offers a variety of classes and programs to help you maintain good health and prevent injury and disease, including services to help you quit smoking.

Symptoms

Symptoms of spondylolisthesis can range from no noticeable symptoms to severe pain. Symptoms can increase during certain activities such as walking or standing, and subside with rest. Common symptoms include:

• Lower back pain, especially after exercise.
• Pain, numbness, tingling or weakness in your leg (sciatica).
• Tightness in your hamstring muscles, which run along the back of your thighs.
• Increased swayback, or curving of your spine.
• Walking with a limp.
• Problems with bowel or bladder control.

Diagnosis and Treatment

To diagnose spondylolisthesis, your doctor will perform a physical exam to assess your range of motion and pain level. Your doctor may also use imaging exams such as X-rays, CT scans or bone scans to diagnose and evaluate your condition. These tests can also help identify whether nearby discs have experienced additional wear and tear due to the slipped vertebra.

Depending on the severity of your condition, your doctor may recommend rest and physical therapy to help you learn how to protect your back and stretch and strengthen your back muscles. In some cases, your doctor may recommend a back brace to support your spine and limit movement, or pain medications to control pain and swelling.

Surgical Treatment

At El Camino Health, doctors use the least invasive treatment methods to alleviate back pain. When nonsurgical treatments aren’t successful, your doctor may recommend surgery if you have:

• Severe pain that doesn't improve with treatment.
• A severely shifted spinal bone.
• Muscle weakness in one or both of your legs.

Surgical treatments, such as spinal fusion, can help relieve spine and nerve pressure, correct spinal alignment and stabilize your spine.

At El Camino Health, spinal surgeons have advanced expertise in minimally invasive spine surgery. Minimally invasive procedures require smaller incisions and can offer less pain and a faster recovery. Your doctor can tell you whether minimally invasive surgery is appropriate for you.