Spondylolisthesis occurs when a vertebra shifts out of place, sliding forward and over the bone below it. This can result in the spinal cord or nerve roots becoming compressed. This condition most often occurs in the lower spine. People with this condition may be asymptomatic for years.
The causes of spondylolisthesis are varied. Genetics may play a role in developing this condition; however, spondylolisthesis is frequently caused by repetitive wear and tear of the spinal column. Teens that are involved in sports, such as weightlifting and gymnastics, develop stress fractures in the vertebrae. Known as spondylolysis, this condition frequently results in spondylolythesis. In adults, degenerative, arthritic changes or diseases may cause the stress fractures, which in turn triggers spondylolisthesis. Less commonly, spondylolisthesis can occur as a result of a traumatic injury that leads to broken vertebrae, in addition to diseases or tumors that have weakened the spine.
Symptoms vary from person to person, but may include pain in the back or buttocks, pain that runs down the back and into the legs, numbness and tingling, weakness in one or both legs, hamstring spasms, and difficulty walking. In rare instances there may be loss of bowel and bladder control. Sometimes those afflicted with spondylolisthesis have no symptoms at all.
Diagnosis of spondylolisthesis is done through X-ray. MRI and CT scans can help pinpoint the exact location of the problem. Treatment options depend on the severity of the condition and include rest, nonsteroidal anti-inflammatory drugs, physical therapy, and the use of a back brace. If extreme pain persists, bones continue to move, or the spinal cord or nerve roots have been damaged, decompression or fusion surgery may be required to reduce nerve compression and stabilize the spine. The use of a cast or back brace may be required, following surgery. Rehabilitation therapy may also be necessary.