What is Spondylolisthesis?
Degenerative spondylolisthesis is a condition that affects the spine as we age. It is more common to be observed in the lumbar (lower back) section of the spine, but can also be seen in the cervical (neck) region of the spine. The condition occurs when one of the vertebras in the spine slips forward onto the one below it.
Additionally, a spondylolisthesis may develop in association with a fracture (spondylolysis). This fracture or lysis coupled with a disc disruption can result in an instability that often is progressive. The progression of the spondylolisthesis can result in deformity, sciatica or neurologic deficit (paralysis).
What Causes Spondylolisthesis
Spondylolisthesis usually develops as we age and is a result of bones, joints, and ligaments in the spine weakening and being less able to hold the structure of the spinal column in proper alignment. Degenerative spondylolisthesis begins to show itself in patients over 50 years of age and becomes much more common after the age of 65. Traumatic or lytic spondylolisthesis is a result of a fracture. Lytic spondylolisthesis can also represent a facture of the spine with an associated slippage of one block of bone onto another. Often painful initially, these then quiet down until the disc degenerates.
Symptoms of Spondylolisthesis
As mentioned earlier, spondylolisthesis is usually seen in the lumbar area of the spine and very rarely observed in the cervical region. For this reason the symptoms listed below pertain to lumbar spondylolisthesis. Cervical symptoms will be similar, but the pain will be felt in your neck and arms instead of the lower back and the legs.
Common signs of spondylolisthesis
It is quite common to feel symptoms of sciatic type pain in the legs as the sciatic nerve is pinched by the spondylolisthesis. Some patient’s primary source of pain will be in the lower back, while others will feel it more in the legs. Symptoms will be more intense while standing as this narrows the spinal canal and causes pinching of the exiting nerves. Most patients will have decreased flexibility and a loss in range of motion. There will also be a difficulty in arching the back, as well as muscular weakness in the legs as the condition progresses.
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