The spinal cord consists of 30 bone segments, which together forms the vertebrae. 24 bone segments in the vertebrae are mobile, connected to each other through joints. As any other joint in the body, these joints also undergo a degenerative process with aging. This biological process results in arthritis or cervical spondylosis, which surfaces itself in the form of stiffness, pain and restricted mobilization of the arm, hands and shoulder.
Two joints in the vertebrae comprise of inferior and superior articular processes. They are called facet articulations, which play an important role in communicating with the adjacent vertebrae. These facet joints are held by fibrous tissue, which are capsules. Because of aging a, these capsules become weakened and thin. This leads to the stretching of these capsules and sliding of vertebrae over one another. This medical condition is called as spondylolisthesis. To tackle the sliding of the vertebrae, the joints thicken into structures. This is called hypertrophy of the facets. These structures tend to impinge into the spinal nerves and canal. This result in spinal stenosis, which is the constant pressure, put on the nerves in the lower back. Spinal stenosis is experienced with degenerative spondylosis.
Survey shows that degenerative spondylolisthesis is most common in people over age 50, and far more common in individuals older than 65. It is also more common in females than males by a 3:1 ratio.
Spondylosis is a condition, which can be confirmed only through an x-ray of the lower back. Patients suffering from this condition may or may not experience pain and discomfort. Unattended cases of spondylosis may lead to a major deterioration in the quality of life in patients.
Symptoms of spondylosis include pain and discomfort in the lower back. Difficulty in walking or performing even daily activities. Numbness, stiffness and problems with movement in the shoulder and neck are few other symptoms.
The treatment of degenerative spondylolisthesis depends on the extremity of the medical condition. In few cases, the physician may prescribe medications and narcotics comprising of anti-inflammatories. One to two days of bedrest may also be recommended. Braces, collars may be suggested to immobilize the back and hence reduce the pain. Physical therapy under the supervision of a qualified therapist may also be beneficial. Degenerative spondylolisthesis can also be controlled by using epidural steroid injections, which helps in tackling any inflammation that exists. Alternative therapies like Ayurveda’s panchakarma therapy and practicing Yoga can also help with effective pain relief.
Operative therapy is adopted in patients suffering from degenerative spondylolisthesis only after all possible methods of non-operative therapy have failed. In the operative therapy, the slipped vertebra is fused into an adjacent vertebra. This reduces the pain and instability. Again, the procedure of autograft can be adopted wherein a bone from the pelvis is placed in between the slipped vertebrae.
This fused bone starts growing over time, reducing the painful movement. To add on, screws may be placed in the pedicles of the spine, which are supported by metal rods. In patients wherein spinal stenosis exists along with degenerative spondylolisthesis, a decompressive procedure may also prove highly effective.