Spondylolisthesis occurs when one of the vertebrae of the spine slides out of place. Though this can happen anywhere in the spine, the most common occurrence is in the lower back (lumbar) region.
Two of the most common types of spondyloisthesis that affect adults are:
Degenerative Spondylolisthesis (DS)
When arthritis develops, the joints and ligaments holding the vertebrae together begin to weaken. This causes the vertebrae to slip forward and form a condition known as spinal stenosis, narrowing the spinal canal and putting excessive pressure on the spinal cord or nerves.
Those most affected by this type of spondylolisthesis are women and those over the age of 50. Studies suggest there is a higher occurrence in the African American population.
A condition that starts in adolescence in most cases, spondylolytic spondylolisthesis is the result of a fracture of the lumbar region of the spine known as pars interarticularis and goes unnoticed until adulthood. The fracture is generally stressed by disc generation and causes the vertebrae to slip forward.
Due to the nature of the pars fracture, only the front portion (vertebrae) of the spinal bone slips forward, making it less likely for pressure to impact the spinal cord. This condition is mostly commonly found in middle-aged men.
Symptoms of Adult Lumbar Spondylolisthesis
Symptoms of DS
Symptoms of DS generally occur after the slippage has begun to put pressure on the spinal nerves and include:
- Leg and/or low back pain
- Numbness, tingling and/or pain affected by posture
- Slight weakness after long periods of sitting or standing
Symptoms of spondylolytic spondylolisthesis
The majority of patients with spondylolytic spondylolisthesis are unaware of their condition, reporting to a doctor only when low back/leg pain is associated with certain activities.
How Is Adult Lumbar Spondylolisthesis Diagnosed?
Following a thorough discussion regarding medical history and symptoms, Dr. LaRocca will conduct a physical examination of the back. By applying pressure to different areas of the spine, Dr. LaRocca can determine where the pain resides. During the exam, patients may be asked to move and adjust their body accordingly, such as bending forward, backward or side-to-side.
Diagnostic imaging tests may be performed to confirm a diagnosis, including:
X-rays: X-rays are used to determine if a vertebrae has slipped forward as well as signs of disc degeneration, such as loss of disc height, bone spurs or spinal instability.
Computed tomography (CT): This scan shows a cross-section of the spine and is more detailed overall than an x-ray.
Magnetic resonance imaging (MRI): MRIs are done to show any damage to the soft tissues including the ligaments, muscles, spinal discs and nerves.
Both DS and spondylolytic spondylolisthesis are diagnosed with these examination tests and techniques.
What Treatments Are Available?
Using the latest advances in the industry, Dr. LaRocca of New Jersey Neck & Back Institute (NJNBI) and his network of experienced physicians provide a variety of minimally invasive surgical as well as non-surgical options including:
- Anti-inflammatory and analgesic medications
- Cortisone injections
- Physical therapy and exercise
- Spinal fusion surgery