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Spondylolisthesis

Spondylolisthesis

(Slipped Vertebra)

Pronounced: spoan-de-LOW-les-THE-sis

Definition

Spondylolisthesis occurs when one of the vertebrae of the spinal column slips out of alignment, moving forward on the vertebra below.

Spondylolisthesis

si1944_97870_1_spondylolisthesis

© 2009 Nucleus Medical Media, Inc.

Causes

Spondylolisthesis is most often caused by a stress fracture of a vertebra, which often occurs in sports activities that put a lot of stress and pressure on the back or overstretches the spine. The condition can also result from congenital disorders of the spine, which are disorders that are present at birth.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

The following factors may increase your risk of spondylolisthesis:

  • Age: 10-15 (This is when most of the progression of the condition occurs, but symptoms may not appear until adulthood.)
  • Rapid growth
  • Being an athlete, especially gymnasts, weight-lifters, and football players
  • Genetic predisposition

Symptoms

In many cases of spondylolisthesis, there are no obvious symptoms. But symptoms may include:

  • Low back pain, which may feel like muscle strain
  • Stiff back
  • Muscle spasms of the hamstring
  • Changes in posture and/or gait
  • Narrowed spinal canal

Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical exam. Other tests may include:

  • X-ray —a test that uses radiation to take a picture of structures inside the body, especially bones (may be performed while you are standing)
  • CT Scan —a type of x-ray that uses a computer to make pictures of structures inside the body
  • MRI Scan —a test that uses magnetic waves to make pictures of structures inside the body

Treatment

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

Physical Therapy

Physical therapy for spondylolisthesis usually involves exercise, especially exercises that strengthen the abdominal muscles and the extensor muscles of the back. A back brace may also be recommended.

If you are overweight, your doctor may instruct you to lose weight.

Medications

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

Injections

Steroid medication injections may help reduce pain. These injections are given around the nerves that exit the spinal cord.

Surgery

If the slippage of the vertebra is severe or if your pain does not respond to other treatments, surgery may be recommended. This may involve fusing two of the vertebra together in a procedure known as 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:

Spondylolisthesis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Accessed July 2, 2007.

Spondylolysis and spondylolisthesis. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=155&topcategory=Spine . Accessed July 2, 2007.



Last reviewed September 2009 by Robert E. Leach, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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