Spondylolisthesis is a condition caused by a vertebra in the lower spine slipping out of position. The condition doesn't always cause symptoms and many people go through life oblivious to them being a sufferer. If symptoms are present, it often means that the slipped vertebra is putting pressure on the nerves around the spine. Symptoms can include; lower back pain which can be relieved by lying down, numbness or tingling sensations travelling down the legs, tight hamstrings, stiffness or excessive curvature in the spine.
Spondylolisthesis can be the result of a birth defect or can occur following a sudden injury. It can also be caused by normal ageing of the spine, very commonly caused by conditions such as arthritis. If you are concerned about the condition you should visit your GP, particularly if you have persistent pain in the lower back, thighs or buttocks or notice that the curve of your back faces excessively outwards.
In order to consider if you are in need of spondylolisthesis surgery your GP will likely carry out a straight leg test. This will involve you lying on your back whilst your GP lifts up your legs by your foot, keeping your knee straight. This is likely to be extremely painful if you are suffering with spondylolisthesis and so if this procedure causes you distress your GP is likely to refer you for further tests. An X-ray will confirm whether you are a sufferer because it will show whether one of your bones is out of place.
There are non-surgical treatments available to help alleviate the pain of spondylolisthesis, including medication, bed-rest or physiotherapy but, if your symptoms are severe you might require spondylolisthesis surgery. There are generally two approaches to the surgery, with a decompressive laminectomy and a spinal fusion being performed during the procedure. The first part of the surgery, the decompressive laminectomy involves removing parts of the vertebra that has slipped out of position so that it can no longer put pressure in the nerve roots. The second part of the surgery, the spinal fusion is essential to strengthen parts of the spine that may have been compromised by removing parts of vertebra. The most common method of spinal fusion is to use bone taken from elsewhere in the body to create a bridge between the affected vertebra and nearby vertebrae. Using donated bone in this manner encourages new bone growth. Another method often used involves using metal implants, such as rods, hooks or screws to secure adjacent vertebrae to the affected area.
It is worth noting that the surgery associated with spondylolisthesis is major and that recovery can mean spending up to a week in hospital and several months before the patient is considered to be back to normal. There are also the usual risks of surgery, such as deep vein thrombosis or infection to be considered. It is always a good idea to discuss the pros and cons with your doctor before embarking on any surgery.
Spondylolisthesis surgery, however is considerered to be highly successful, with most people noticing a vast improvement in their symptoms just three months post-surgery. This improvement usually continues for up to four years after surgery, with many patients reporting reduced leg and back pain and an increase in activity. It seems, that often surgery might be the answer.