Spondylolisthesis is a pathological condition of the spine, characterized by the displacement of one vertebra forward or backward in relation to the adjacent vertebrae. This condition can lead to deformity of the spinal column, narrowing of the spinal canal or squeezing of the nerve roots coming out of the intercostal holes. This disease develops in about 5% of people.
The causes for different types of spondylolisthesis are different. It can be:
- congenital anomaly of development (defect) in the vertebra;
- heavy long loads on the spine, overstretching (often in gymnasts, rugby players and
The risk factors for this disease include the presence of spinal diseases in relatives, overdistension, or repeated injury of the lower back and lumbar spine. First of all, weightlifters, gymnasts, rugby players and other athletes, whose spine is affected by large forces during stretching, are at risk for this pathology.
Symptoms of spondylolisthesis
As a rule, in 80% of cases, clinical manifestations in patients with spondylolisthesis are not observed. The most frequent clinical manifestation of spondylolisthesis is pain in the lower back, which increases after exercise, especially aimed at stretching the lumbar spine. Also often there is a tension of the hamstring, a decrease in the amplitude of movements of the lower back. Sometimes there is numbness, pain, tingling or weakness in the legs due to compression of the nerve endings. Strong nerve compression can lead to loss of control over the bowels or bladder or cause horsetail syndrome (loss of sensitivity and paralysis of the pelvic organs, buttocks, legs).
Visually, spondylolisthesis is usually not detected, but can be detected on a radiograph. In order to clarify the degree of displacement of the vertebrae make side radiographic images. Spondylolisthesis of the I degree is characterized by a displacement of up to 25% of the vertebral body, II Art. – up to 50%, III Art. – up to 75%, IV Art. – more than 75%, V degree of spondylolisthesis is characterized by complete detachment from the adjacent vertebra (spondyloptosis).
If the patient has symptoms indicative of compression of the spinal nerve roots, computerized and magnetic resonance imaging is also used.
Types of disease
Depending on the direction of displacement of the vertebra relative to the spinal column, two types of spondylolisthesis are distinguished:
- anterolisthesis – forward displacement of the vertebra;
- retrolistez – displacement of one vertebra posterior to other vertebrae.
Given the etiological origin of spondylolisthesis, the following types of it are distinguished:
- dysplastic (that is, spondylolisthesis, arising from a congenital defect of the vertebra, allowing the vertebra to move forward);
- isthmic spondylolisthesis (arising on the background of spondylolysis – a small fracture of the interarticular bone region);
- degenerative spondylolisthesis (occurs in the elderly due to arthritic changes in the intervertebral joints against the background of degenerative processes in the cartilage tissue);
- pathological spondylolisthesis (bone defect due to, for example, a tumor process);
- traumatic spondylolisthesis (arises from direct injury or damage to the vertebrae).
In case of pain in the lower back against the background of injury, degenerative changes, or for no apparent reason, it is recommended to consult a specialist.
Conservative treatment involves the use of nonsteroidal anti-inflammatory drugs, steroid drugs, as well as the use of manual therapy, physiotherapeutic methods of treatment, microfarmatuncture and epidural injections. The gold standard for the surgical treatment of spondylolisthesis is the fusion of the lumbar vertebra (spinal fusion) with metal fixation.
Complications of spondylolisthesis are chronic pain in the lower back and legs, weakness and numbness of the lower extremities, problems with control of bowel and bladder emptying, progression of impaired posture and deformity of the spinal column.
For preventive purposes, it is recommended to do daily exercises, paying particular attention to exercises to stretch the back muscles, as well as to those exercises that generally strengthen the muscular frame of the back. You should also avoid excessive loads on your back, especially its lumbar section.