Adults are prone to Spondylolisthesis in the lower back as the entire weight of the body is borne by the lower back. As aging progresses, weight increase and lifestyle changes occur, resulting in the lower back taking the brunt of the load. As wear and tear increases vertebrae slip out of place leading to Spondylolisthesis.
There are many types of Spondylolisthesis which affect adults, but the two most common types are Degenerative and Spondylolytic. There are other types of Spondylolisthesis which are less common such as slippage of the vertebra caused by fracture or tumor.
Degenerative Spondylolisthesis occurs as we age with general wear and tear in the spine. This causes the Intervertebral discs to begin to dry out and weaken. They lose height, become stiff and begin to bulge. This disk degeneration is the beginning of both arthritis and degenerative Spondylolisthesis. As the arthritis develops, it weakens the joints and ligament that hold your vertebrae in proper position, causing the ligament along the back of your spine to begin to buckle and this leads to slippage by the worn vertebrae moving over, forward or below the vertebrae below it.
Spondylolytic Spondylolisthesis is the second most common occurrence of Spondylolisthesis. “Spondylolytic” refers to a fracture. One of the bones in your lower back can break and cause a vertebra to slip forward. This break occurs in the area of your lumbar spine called “pars interarticularis”. In most cases of Spondylolytic Spondylolisthesis the pars fracture occurs during adolescence and goes unnoticed until adulthood. The normal disk degeneration that occurs in adulthood can then stress the pars fracture and cause the vertebra to slip forward.
Symptoms of Degenerative Spondylolisthesis manifest only when the slippage has begun to put pressure on the spinal nerve resulting in leg or lower back pain. No pain is felt when the fracture actually occurs and you may be surprised to find that you have a fracture in the pars and slippage when seen in x-rays.
The most common symptoms in the legs include a feeling of vague weakness associated with prolonged standing or walking. Leg symptoms may be accompanied by numbness, tingling and pain that is often affected by posture.
While non-surgical treatment will not repair the slippage, physical therapy and exercise do help relieve symptoms as specific exercises can strengthen and stretch your lower back and abdominal muscles. Medication with analgesics and non-steroidal anti inflammatories also relieve pain. Alternative Therapies like Yoga and Ayurveda have gained a lot of popularity for being extremely effective in providing long term relief with no side effects. Surgical treatment is generally reserved only for patients who do not improve with non-surgical treatment.