Instability / Spondylolisthesis

What Is Spondylolisthesis?

Spondylolisthesis occurs when a vertebra shifts relative to an adjacent vertebra, causing stress on the disc and ligaments of the spine, and likely compressing nearby nerves. Symptoms of spondylolisthesis range from no symptoms at all to debilitating pain and nerve dysfunction. While it may be painful when left untreated, most patients find meaningful long-term relief with physical therapy, medication, or surgery.

Types of Spondylolisthesis

Five types of spondylolisthesis exist:

  • Degenerative spondylolisthesis occurs due to age-related degenerative changes in the disc and facet joints of the spine. The discs that support the vertebrae tend to thin over time, which can cause vertebrae to slip out of position. This is the most common type of spondylolisthesis seen in adults.
  • Isthmic spondylolisthesis is the most commonly seen spondylolisthesis in adolescents and young adults. It is most often caused by a stress fracture in the pars articularis. Symptoms of this type of spondylolisthesis may not occur until months or even years after injury.
  • Traumatic spondylolisthesis occurs when a traumatic injury causes damage to the vertebra or supporting structures to the extent that the vertebrae are no longer held close together and move abnormally.  This condition nearly always requires surgery to prevent neural injury.
  • Congenital spondylolisthesis is caused by abnormal development of the spine in utero.

Symptoms of Spondylolisthesis

Common symptoms of spondylolisthesis include:

  • Lower back pain that is made worse by physical activity
  • Shooting pain into the extremities
  • Numbness or tingling radiating into the extremities
  • Stiffness of the lower back and legs
  • Muscle tightness and immobility

Diagnosis of Spondylolisthesis

Patient medical history and physical exam are the first steps in diagnosing spondylolisthesis. Additional workup will include spinal imaging studies.  X-rays, MRI, and/or CT scans may be necessary to adequately assess the nature of the spondylolisthesis and guide treatment decisions.

Treatment for Spondylolisthesis

Treating spondylolisthesis usually begins with non-invasive treatments. In most cases, these treatments are successful in relieving the condition.  These include:

  • Heat or ice compresses
  • Physical therapy and stretching
  • Oral medications
  • Steroid injections

Surgery for Spondylolisthesis

A doctor may recommend surgical treatment of spondylolisthesis for more debilitating cases of the condition. Spondylolisthesis requiring surgical intervention almost always requires spinal fusion, as decompression alone is likely to result in worsening spinal instability.

Schedule a consultation with Dr. Ditty to discuss your surgical options. Dr. Ditty and his team will guide you through the steps you need to take for pre-surgical preparation and post-surgical recovery, including nonsurgical lifestyle changes to prevent further pain or complications.

Call (239) 337-2003 today to schedule a consultation or learn more.

I was overwhelmed by Dr. Ditty’s caring attitude and knowledgeable presentation of what had to be done to fix the issue I was having. I really believe Dr. Ditty is the right neurosurgeon for me.

Janis A.

June 2021

From the receptionist to the X-ray tech, to Kelly, his PA and Dr. Ditty is exemplary. The environment is soothing, the staff is welcoming and Dr. Ditty and Kelly are superb. I had an extensive back procedure with complications that had nothing to do with the procedure and was treated kindly, knowledgeably and professionally.

Mark L.

I ask lots of questions. Dr. Ditty answered all of them, and everything turned out just as he said. I am very grateful I choose him to do my back surgery.

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