The grades are:. A person may have had spondylolisthesis since birth and never experienced any symptoms from it.
Types of Spondylolisthesis
It is common for a person to develop symptoms as they age, however. Symptoms can range in severity from non-existent to a loss of urination and bowel movement control in more severe cases. The causes of spondylolisthesis vary.
Some people are born with a defective vertebra that may not be identified until much later in life. Others experience an injury to the back either repeatedly or on one occasion only. Knowing the cause can help a doctor determine the type of spondylolisthesis a person has, as well as help determine the best treatment. In many cases, a person may not know they have spondylolisthesis as they may have no symptoms. In these cases, a doctor might discover the condition during an exam for something else entirely. Diagnosis starts with a physical exam and questions about what kind of pain or numbness the person is experiencing.
If a doctor suspects spondylolisthesis, they will order an X-ray of the back. Visual examination of the X-ray is often enough to determine if a person has spondylolisthesis, as well as to decide the grade. In some cases, a doctor may order additional imaging to find the exact locations of the fractures to help guide the individual's treatment. The cause of spondylolisthesis can often be found by the initial questions about when and how the symptoms started.
A person can start treatment at home through a variety of methods, including using over-the-counter medication for pain relief. In cases where overuse has caused the spondylolisthesis, a person should stop any activities that aggravate the pain.
Additionally, someone who is overweight might want to consider losing weight, which may help alleviate their symptoms. A doctor can prescribe additional pain relief and anti-inflammatory medications if necessary. They may also order physical therapy. Physical therapy will help a person build up core muscles in the midsection of their body and back. Physical therapy can also include stretching to help relieve pain and improve flexibility. In more extreme cases, a doctor might recommend surgery. Surgery is usually reserved for cases where there is spinal damage, the vertebra continues to slip, or the pain is extreme.
Surgery can remove excessive bones or fuse the vertebrae back together.
WHICH TYPE IS MOST COMMON?
If surgery is used, a person will need to take the appropriate steps to recover from the procedure afterward. Some people may go their whole lives without knowing they have spondylolisthesis.
Others may find out during an unrelated visit to the doctor's office or when being diagnosed with another disorder. For those who experience pain, numbness, or other symptoms, the overall outlook is still very good. Most people can manage their spondylolisthesis with a combination of therapies and medication. In the most extreme cases, a person may consider surgical options. After surgery, the individual can expect a recovery period lasting several weeks or months before being able to return to normal activities. Article last reviewed by Mon 14 August Visit our Back Pain category page for the latest news on this subject, or sign up to our newsletter to receive the latest updates on Back Pain.
All references are available in the References tab. Standaert, C.
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The diagnosis and management of lumbar spondylolysis. Weinstein, J. A small amount of radioactive tracer is injected into a vein. As the tracer circulates in the blood, it is absorbed by the tissues and then gives off energy. The energy is seen by the CT scanner and can detect stress fractures, spondylolysis, infection, and tumors by the differences in how the radioactive substance is absorbed by normal healthy tissue vs.
First, athletic activity should be stopped to allow the fracture to heal. Conservative nonsurgical treatment is the first step and may include medication, rest, physical therapy, home exercises, hydrotherapy, a brace, and pain management. Periodic x-rays will allow the doctor to watch the degree of slippage. Surgery may be needed if slippage continues or if your pain is not relieved by conservative treatment.
The lower back lumbar curve bears most of your weight, so proper alignment of this section can prevent further slippage and injury to your spinal nerves and discs.
You may need to make adjustments to your daily standing, sitting, and sleeping habits. You may also need to learn proper ways to lift and bend see Self care for Back Pain. You may need to wear a back brace for a short period of time while you strengthen the abdominal and lower back muscles. The brace may decrease muscle spasm and pain as well as help immobilize your spine and help the healing process.
Your doctor may refer you to an orthotist who specializes in custom-made braces. Physical therapy : The goal of physical therapy is to help you return to full activity as soon as possible. Exercise is very helpful for pain and it can help you heal faster. They'll also encourage you to increase the flexibility of your spine and legs. Medications : Your doctor may prescribe pain relievers, nonsteroidal anti-inflammatory medications NSAIDs , and steroids. Sometimes muscle relaxers are prescribed for muscle spasms.
Long-term use of analgesics and NSAIDs may cause stomach ulcers as well as kidney and liver problems.
Steroids can be used to reduce the swelling and inflammation of the nerves. They are taken orally as a Medrol dose pack in a tapering dosage over a 5-day period. They have the advantage of providing pain relief within a hour period. Steroid injections: This minimally invasive procedure is performed with x-ray guidance and involves an injection of corticosteroids and a numbing agent into the spine. The medicine is delivered right into the painful area to reduce the swelling and inflammation of the nerves. Repeat injections may be given to achieve full effect.
Duration of pain relief varies, lasting for weeks or years. Epidural steroid injections : An injection of corticosteroid and a numbing agent is delivered into the epidural space of the spinal canal or nerve root canals to reduce the swelling of the nerves. Facet injections: An injection of corticosteroid and a numbing agent is delivered directly into the painful facet joint. Spinal fusion can address both the instability of the spine and compression of the nerve roots.
The surgeon first performs a laminectomy to decompress the nerves. Pedicle screws are inserted into the bones above and below the slip. Then the surgeon leverages the screw to pull the bones back into alignment and secures it with a rod Fig. Over the next 3 to 6 months new bone will grow across the graft, permanently joining the two pieces of bone Fig. The increased physical activities of adolescence and adulthood, along with the wear-and-tear of daily life, result in spondylolisthesis being most common among adolescents and adults.
Spondylolisthesi: Causes, Symptoms, Treatments
Many people with a spondylolisthesis will have no symptoms and will only become aware of the problem when it is revealed on an x-ray for a different problem. However, there are several symptoms that often accompany spondylolisthesis:. Professor Rodts has done an excellent job at distilling the basics of spondylolisthesis into a concise easy to read layman's format.
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