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Spondylolisthesis

Spondylolisthesis is a condition in which one vertebra slips forward over the one immediately below it. It has multiple causes and can occur anywhere along the spine, although it is more common in the lumbar and cervical regions. Between 5-10% of the adult population who seek a consultation with a spinal surgeon for back pain will have an X-ray that shows spondylolysis and/or associated spondylolisthesis.

4-6 %

This condition affects 4-6% of the general population, with higher prevalence in women over 50 years of age.
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10 %

About 10% of patients with lumbar spondylolisthesis experience instability requiring surgical stabilization.
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What causes spondylolisthesis?

Spondylolisthesis generally occurs following a traumatic event or overload. When it is a consequence of aging, it is referred to as degenerative spondylolisthesis.

Symptoms

Spondylolisthesis can remain asymptomatic for years, and in many cases, throughout life. When symptoms do occur, they may include:

  • Back pain extending to the buttocks
  • Numbness in the limbs
  • Muscle stiffness
  • Pain and weakness along the legs
  • Sudden pain in the lower back
Diagnosis

The diagnosis of spondylolisthesis is confirmed through spinal X-rays, which reveal vertebral slippage (spondylolisthesis) and bony discontinuity of the isthmus (spondylolysis). To get a clearer picture of the condition, further tests may be conducted, such as:

  • MRI to assess the condition of intervertebral discs and possible nerve root involvement
  • CT scan for potential pre-operative planning
Treatment

The most common treatment involves rehabilitation and physical therapy alongside pharmacological therapies. In more severe cases, surgical intervention may be necessary, with several techniques available to primarily relieve and/or reduce pressure on the nerves, stabilizing the affected vertebral segment. Surgical treatment options for spondylolisthesis include:

  • Traditional open surgery (laminectomy and fixation with screws and rods)
  • Minimally invasive surgery without the need to open the vertebral canal (indirect decompression)
  • Spinal fusion