Definition of Spondylolisthesis

If a person experiences a forward slip of one vertebra (a bone in the spinal column), this is called a spondylolisthesis. It usually occurs in the lumbar region, or near the base of the spine, and is one of the most common causes of persistent back pain, according to the Spine Institute of New York. Spondylolisthesis causes pain if it compresses (pinches) a nerve.

Prevalence

• About 5 to 6 percent of males and 2 to 3 percent of females have a spondylolisthesis, according to SpineUniverse.com. The condition most commonly occurs in teenagers and adults. Not everyone with spondylolisthesis experiences symptoms, and symptoms occur more often in people performing very physical activities such as lifting weights or playing football.

Types

• Developmental spondylolisthesis is present at birth, although this is a rare condition. Acquired spondylolisthesis, in contrast, can occur due to degenerative causes or trauma. Regular stress on the spine from activities such as sports and heavy lifting cause degenerative spondylolisthesis. If caused by osteoporosis, it is referred to as pathological spondylolisthesis. Traumatic spondylolisthesis can occur from actions such as jumping or falling from a high area and landing on one's feet. Spondylolisthesis is most commonly caused by spondylolysis, or a crack in a vertebra. This usually involves a stress fracture in the lower part of the spine.

Risk Factors

• People with an abnormal forward curvature of the lumbar spine (swayback) are more at risk for developing a spondylolisthesis. Individuals participating in contact sports such as football or volleyball also are at higher risk, as are those who perform certain types of gymnastics. Postmenopausal women also are at greater risk because they are more likely to have osteoporosis.

Symptoms

• Because it may cause no symptoms, spondylolisthesis is sometimes diagnosed when a person has an x-ray for a different back problem. The most common symptoms include low back pain, pain or weakness in one or both legs, tight hamstring, increased inward curvature of the spine and decreased bowel and bladder control. Low back pain is particularly likely after exercise. People with advanced spondylolisthesis may acquire a waddling gait.

Treatment

• People with pain symptoms from spondylolisthesis may need to rest and avoid sports. Physical therapy can help relieve spondylolisthesis symptoms as well. A doctor may prescribe non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief, along with temporary use of braces, a corset or a cast to allow a fracture to heal. If none of these treatments are effective, the doctor may recommend decompressive laminectomy, a surgical procedure which frees the pinched nerves.