15-03-2020

What is spondylolisthesis? Everything you need to know about this lesion

Spondylolisthesis is a lesion in which one vertebra slips over another. The experts in pathologies of the spinal column at Instituto Clavel explain more about this affliction here, everything from the most common causes to the types of treatment available.

In this post we are going to talk about a pathology with a complicated nomenclature: spondylolisthesis. A spinal problem that arises when one of the vertebrae slides forward over another one. Although it can happen anywhere in the spine, even at the cervical level, the truth is that it occurs more frequently in the lower back. Specifically, in the last segments (L4-L5-S1).

Spondylolisthesis is classified in two types according to where the displacement occurs:

  • Anterolisthesis: if the vertebra slides forward.
  • Retrolisthesis: if the vertebra slides backward. 

One of the main problems with this pathology is that it does not always cause any symptoms, and patients do not go see a spine specialist until the problem has become serious and causes several kinds of discomfort. 

Causes of spondylolisthesis

Some people are born with this problem and others develop it during childhood. However, it is usually not detected until adolescence, or even adulthood, when it begins to cause pain. 

It can arise at any time for one of three reasons. On the one hand, it may be due to daily pressure on the spine due to poor posture, lifting heavy loads or repeated sports activity in which the spine is involved. On the other hand, it can appear due to the degeneration of, or wear on, the bones of the spine, that is, the weakening of the connections between the vertebrae due to age.  

Furthermore, in addition to the causes listed above, spondylolisthesis can be due to injury, it can be the result of a blow, a fall, or an accident. 

Main symptoms of spondylolisthesis

As we said earlier, spondylolisthesis can be asymptomatic, especially in cases that are not too severe. However, with the passage of time, it usually becomes worse and begins to cause discomfort. The main symptoms are as follows:

  1. Pain in the affected area, which may irradiate to the thighs or legs.
  2. Weakness in the legs.
  3. The muscles on the back of the thighs (hamstrings) pull tight.

Often, this spinal lesion can alter some physical aspects of the person who has it. The abdomen may bulge, the torso may appear shorter, the curvature of the lower back may appear too pronounced, etc.

Obviously, not all scenarios are the same. Spondylolisthesis can have different degrees of severity. In fact, a scale of 1 to 5 is used, where 1 is the mildest and 5 the most severe. The severity of the lesion is established based on the percentage in which the vertebra has moved forward. In the worst case, grade 5 occurs when the slip reaches 100%, which is known as spondyloptosis. When this happens, the bone may put pressure on the medulla or the nerves.

Treatments for spondylolisthesis

Once the problem has been diagnosed, which is usually done using a combination of tests ranging from conventional x-rays to MRI and lumbar scanning, treatment is chosen based on the severity of the injury. At Instituto Clavel we attach great importance to this step, since it is the foundation that allows us to choose the most appropriate solution for each patient. In order to ensure this, in our case, in addition to the aforementioned tests, we have the EOS scanner, which yields a high-quality complete image of the patient's spine, with the patient standing and exposing the patient to a much lower dose of radiation than conventional x-rays. The fact that it is done with the patient in a standing position is very important, because this way it is easier to see the effect of the weight load on the vertebra. On MRI or scanner, the patient is lying down, and sometimes displacement is not seen or severity is underestimated.

Depending on the state of each lesion, we have various treatment alternatives, ranging from conservative options to surgical intervention. If the lesion is mild, we usually begin with conservative treatments, which usually include specific medication and exercises to strengthen the muscles of the spine, as well as a series of guidelines to establish good postural habits.

If the pain is severe or does not improve with the conservative treatments, the next choice is surgery to correct the spondylolisthesis

The good news is that at Instituto Clavel we know this pathology well. Our extensive experience, combined with advanced technology, allows us to provide a solution to the problems of the spine in a minimally invasive way in the vast majority of cases. If you suffer any of these symptoms and you want to be evaluated by a specialist, do not hesitate to contact us so that we can help you in a completely personalized way.

Can spondylolisthesis be prevented?

There is no method that will guarantee prevention of this type of lesion, however, there are methods of reducing the risk of it occurring. A healthy lifestyle is the key. Here below are some tips to follow:

  • Mind your posture.
  • Try to maintain a healthy body weight, because excess weight increases pressure on the lumbar area. 
  • Avoid activities that are likely to cause spinal injury, such as carrying heavy loads.
  • Do low impact sports, like walking or swimming
  • Keep y our back and abdominal muscles strong
  • Make healthy food choices. 

Although as we said, there is no 100% guarantee, the truth is that adopting all these habits will help you take care of your health in general and feel much better. Even if you already have a back problem, at Instituto Clavel we want to remind you that making these kinds of changes will make a difference. What are you waiting for?

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