What Are the Symptoms of Spondylolisthesis?
In many cases, people with spondylolisthesis do not learn of their condition until they undergo an X-ray exam for an unrelated injury or symptom. Children may not exhibit any symptoms until they are 18 years old. When symptoms occur, they may vary from mild to severe. The most common spondylolisthesis symptom is lower back pain. Other spondylolisthesis symptoms may include:
- Leg or lower back pain, including weakness associated with prolonged standing or walking.
- Lower back pain that radiates to the buttocks and back of the thighs.
- Back stiffness.
- Tight hamstrings (the muscles in the back of the thigh).
- Difficulty standing and walking.
- Tenderness in the area of the vertebrae that are out of place.
Patients with severe spondylolisthesis or high-grade slips may experience increased and abnormal lordosis (also called swayback). In later stages, it may develop kyphosis (roundback) as the upper spine falls off the lower spine.
How To Diagnose Spondylolisthesis?
- Medical History and Physical Examination - If you have symptoms of spondylolisthesis, your doctor may ask about your medical history and perform a physical examination of different areas of your back. You may be asked to do certain movements, including bending forward, backward and side-to-side, to look for areas of tenderness, limited range of motion, muscle spasms and muscle weakness.
- Imaging Tests - Your doctor may request additional imaging tests to help confirm the diagnosis of spondylolisthesis. Diagnostic tests may include the following:
- X-rays.
- Computed tomography (CT) scans.
- Single photo emission computed tomography (SPECT) scans.
- Magnetic resonance imaging (MRI) scans.
How To Treat Spondylolisthesis?
Spondylolisthesis treatments aim to reduce pain, allow a recent pars fracture to heal, and return the patient to sports and other daily activities. Although conservative treatments will not repair vertebral slippage, they are usually enough to treat the symptoms and help relieve pain.
Spondylolisthesis Treatment Without Surgery
Your doctor may recommend the following nonsurgical spondylolisthesis treatments:
- Rest. Avoid sports and other activities that cause excessive stress on the lower back to help improve back pain and other symptoms.
- Physical therapy and exercise. Engage in specific activities that can strengthen your lower back and abdominal muscles and improve the flexibility of your tight hamstrings.
- Medication. Take analgesics and nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen and naproxen, to help relieve pain.
- Steroid injections. Decrease pain and swelling through cortisone injected around the nerves or in the outermost part of the spinal canal.
- Bracing. Wear a back brace for some time to limit movement in the spine. However, bracing is not recommended for patients with longer-term pain due to their low chance of healing, even after several months in a brace.
Surgical Treatment
Spinal fusion is an option if noninvasive treatments fail to treat symptoms due to severe or high-grade slippage, progressively worsening slippage and chronic back pain that does not go away even after nonsurgical treatment.
The goals of spinal fusion are to prevent further slip progression, stabilize the spine and alleviate significant back pain by fusing the affected vertebrae so that they heal into a single, solid bone.
Recommendations
Patients with degenerative spondylolisthesis and isthmic spondylolisthesis can benefit from nonsurgical treatment. When spondylolisthesis surgery is required, patients with spondylolisthesis experience improved symptoms, sometimes within a few weeks or several months after the procedure.
If you have had surgery to treat spondylolisthesis, your doctor may recommend specific stretching exercises to strengthen your back and abdominal muscles to help prevent future injury. Make sure to schedule regular check-ups to prevent problems from developing post-surgery.