Spondylolisthesis happens when your spine becomes unstable and one vertebra in your back slips over another, causing back pain and weakness in one or both legs. Treatment focuses on eliminating symptoms of spondylolisthesis and strengthening back muscles and can include medication, physical therapy or surgery.

What is Spondylolisthesis?

The bones in your spine (vertebra) have small joints that keep the spine aligned for proper function and stability. Spondylolisthesis is a problem with these small joints which causes instability in the vertebra, allowing one vertebra to slip under another. When spondylolisthesis happens, it can cause the spinal cord or nerves to be pinched, which can cause back pain, leg numbness or weakness or bowel or bladder control problems. In rare instances, spondylolisthesis can occur in the neck and cause neck pain, arm pain, numbness or weakness.

Baptist Health is known for advanced, superior care for patients with problems with the spine and the diagnosis, management and surgical and non-surgical treatment of spondylolisthesis. Our 24/7 inpatient neurology and neurosurgery services, as well as our outpatient services, Home Health, physical and occupational therapy services are available to help treat people with spondylolisthesis. In addition, we have the region’s only advanced 3Tesla MRI, MRI spectroscopy and functional MRI, to accurately diagnose and optimally treat all manner of neurologic spine disease including spondylolisthesis.

You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.

Signs and Symptoms

Spondylolisthesis may not cause any symptoms, but most times, one or more of these symptoms are present:

• Low back pain and buttock pain
• Pain that runs from the lower back down one or both legs
• Muscle spasms at the back of the thighs
• Numbness or weakness in one or both legs
• Leg, back or buttock pain that gets worse when you bend over or twist

Diagnosis

To determine if someone has spondylolisthesis, we do a thorough physical exam and ask about medical history and how and when pain first occurred. We then use advanced diagnostic procedures and technology to effectively diagnose, inform treatment and carefully monitor the condition. Diagnostic tests and procedures can include:

CT scans: X-rays and computers can be used to create images of the spine and nerves.
Magnetic Resonance Imaging (MRI): A large magnet, radio waves and a computer are used to make pictures of the spine and nerves.
X-ray: A common imaging test is used to look for decreased space between discs, break-down of joints, bone spurs, hardened nerve bundles and spine problems when flexing legs or arms.

Causes

In rare cases, spondylolisthesis is present at birth. But spondylolisthesis is most often caused by damage to the joints or vertebra. Damage can happen by:

• Injury from falls, auto accidents or other trauma
• Sports like gymnastics, football and weightlifting
• Infection

Risk Factors

Risk factors for a spondylolisthesis can include:

Age: Aging wears out the spine and makes it easier for a vertebra to slip.

Prevention

While some risk factors like age cannot be controlled, there are ways you can help prevent spondylolisthesis:

Strengthen back and abdominal muscles: Strong muscles in your back and abdomen help support and stabilize your lower back.
Maintain a healthy weight: Maintain a healthy weight, or lose extra weight to help keep stress off of your spine.
Eat a well-balanced diet: Watch what you eat for good bone health.

Prognosis

Prognosis for a spondylolisthesis depends on the severity of the condition, but treatment is often highly successful in eliminating pain.

Treatment and Recovery

Treatment for spondylolisthesis aims to lower or end pain symptoms and strengthen back muscles that support the spine, and can include:

Medication

Pain medications can be prescribed to control pain and inflammation.

Physical therapy

A physical therapist can teach the best ways to build stomach and back muscles and how to exercise without pain. Physical therapy techniques, such as traction, can be very effective at decompressing the spine and nerves and often results in long-term success at controlling symptoms. Exercise helps reduce the risk of fractures and prevents bone loss. It also helps people who are overweight lose the weight that can cause stress on the spine.

Surgery

If other treatments are not effective and pain continues, surgery may be necessary. In some surgeries, tissue or bone that presses on nerves is removed. Sometimes, when the cause of the pain is removed, the spine becomes unstable. In those cases, another surgery is done at the same time to help bones grow together to make the spine sturdier. Sometimes a back brace is necessary right after surgery to help stabilize the back.

Recovery After Surgery

After surgery, your incisions may take one to two weeks to heal. Your surgeon will give you a plan to recover. It is important not to overdo it. If you get a fever, an infection or your pain increases, call your doctor immediately. You will need physical therapy to stretch your back and limbs and strengthen the muscles in your back to support your spine. As you gain strength, it is important to:

• Eat a healthy diet
• Exercise to increase blood flow to your back and limbs and improve your balance
• Lose weight

Complications

If not treated, complications of spondylolisthesis can include:

• Chronic pain
• Permanente nerve damage
• Reduced mobility
• Weight gain