What are spondylolysis and spondylolisthesis?
Spondylolisthesis is when one of the bones of the spine (vertebrae) slips forward compared to the one below it. It can occur for a number of reasons which will be reviewed below. One reason is due to spondylolysis which is when there is a break in one or both sides of the posterior ring of a vertebrae. The part of the vertebrae that breaks is called the pars. This condition is most common in the fourth and fifth lumbar vertebrae which are near the bottom of the spine.
How does it occur?
Spondylolisthesis (forward slipping) can occur for a number of reasons including:
It can be congenital (born with predisposition due to angle of joints) – most often shows up during adolescent growth spurt
It can be degenerative- more common in women
It can be due to bone disease such as tumor, infection, osteoporosis etc.
It can be due to surgical procedures removing portions of the posterior vertebral structure
Spondylolysis (breakage in the portion of vertebrae called the pars) can occur from:
Repetitive extension of the back which then causes weakness in the pars
Less commonly it occurs from an injury to the back
The athletes most prone to this injury are gymnasts, dancers and football players
What are the symptoms?
Lower back pain and spasm- can be intermittent or constant
If severe enough, you may experience numbness, tingling, or weakness in the legs
How is it diagnosed?
History and physical examination looking for tenderness, spasm, feeling vertebrae
How is it treated?
For acute pain the doctor may prescribe pain medication or anti-inflammatories
Physical therapy including stabilization exercises
Avoiding hyperextension (excessive backward bending)
Severe cases may require surgery
Avoid becoming overweight as spondylolisthesis is a chronic problem