Spondylolisthesis – An overview.

By avn
7:08 am Posted June 10, 2016
In Spondylolisthesis

Spondylolisthesis literally means Spine Slippage which is nothing but a condition when a vertebrae tends to slip forward onto a bone that sits beneath it. Most often, this happens in the lower vertebra or the lumbar region of the spine.

It is described according to its severity and graded on a scale of 1-5 with 1 being the least advanced and 5 being the most advanced. The grade is measure of the percentage slippage of the vertebra and is as follows.

Spondylolisthesis Table

The below picture depicts the various grades for better understanding.


Symptoms of spondylolisthesis

Most often, people who suffer from this condition show no symptoms and realise it only when they see an X-ray taken for a completely different problem. Having understood this, you should also be aware that there are certain symptoms that accompany this condition such as :

  • Pain in the Lumbar spine or the lower back, especially after exertion.
  • Increased lordosis which is nothing but an excessive inward curvature of the spine
  • Weakness and/or Pain in one or both of thighs or legs
  • Reduced control on bowel and bladder functions
  • Tight hamstring muscles
  • In cases where this condition is advanced, there maybe noticable changes in ones style of walking or standing. When the curvature of the spine is increased inward, the abdomen tends to protrude out and result in a waddling style of walk.

Symptoms of spondylolisthesis

For easier understanding, the condition has been classified into types.

    • Type 1 – Caused due to a congenital condition

This is a birth defect in the articular processes of the vertebrae. It is usually observed in the L5-S1 area where the last Lumbar vertebra tends to slip onto the sacrum.

    • Type 2 – Caused due to fracture of pars interarticularis

The fracture maybe multiple micro fractures or partial fracture or a complete fracture and basis this, they are sub-classified.Problems with the pars interarticularis can generally referred to as spondylolysis. So, the fractures are called spondylolysis and the condition when the vertebra slips forward because it’s not being held in place properly, it’s called spondylolisthesis.

    • Type 3 – caused due to ageing

As a part of the natural ageing process, the intervertebral discs tend to lose their integrity and becoming thinner thereby bringing the facet joints together. When the discs loose their flexibility to act as a cushion, the facet joints become hypermobile and result in the vertebra slipping. This is most common in the L4-L5 area and in women above 50 years.

    • Type 4 – caused due to fracture of any other part other than pars interarticularis.

Sometimes, the slippage occurs due to a fracture of the facet joints.

    • Type 5 – Caused due to Tumours

Tumours on the vertebra tend to weaken the bones and cause fractures that lead to spondylolisthesis.

    • Type 6 – Caused due to a previous surgery.

A Laminectomy surgery can lead to the pars weakening, thereby resulting in spondylolisthesis.

Treatment of Spondylolisthesis

The treatment plan for spondylolisthesis is determined basis the severity and the degree of slippage. Conservative treatment is the most preferred route, like in most cases and these include :

  • wearing a back brace
  • physical therapy.
  • Pain medication
  • Epidural injections
  • Alternate healing methods like Yoga and Ayurveda are also extremely effective in relieving symptoms. While a good Yoga routine helps strengthen the core muscles and manage pain effectively, the various massages in Ayurveda like Podikkizhi (Herbal powder massage), Ilakkaizhi (Herbal leaves massage), kativasthi (Pooling medicated oil in the back), Pizhichil (Pouring medicated oils as a stream), Nhavarakkizhi (Massage with rice boiled in medicated milk) and the Panchakarma therapies with medicated enema like Kashaya Vasthi (enema with medicated decoctions) and Ksheeravasthi (Enema with medicated milk), when done under the supervision of a trained Ayurveda professional can help treat even the severest conditions without surgical procedures.

Surgery is opted by very few people as a last resort when they have found little relief with the non-surgical options and their quality of life is severely impacted by pain.
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