Spondylolisthesis is a condition in which a vertebra in the spinal column slips backward or forward and out of its original place. If a vertebra slips too much, it can press on a nerve and cause pain. The term spondylolisthesis derives from two words: spondylo which means spine and listhesis which means slippage. This condition most often occurs in the lumbar area at the base of the spine.
This condition is most commonly diagnosed in adults caused by degeneration of the discs and ligaments that bind and support the spine. Spondylolisthesis often begins in the teenage years, and with age, the intervertebral discs lose water content and ultimately height. As the vertebrae on either side of the disc come closer to each other, the upper vertebra slides forward over the sub-adjacent vertebra.
Spondylolisthesis can also be associated with deterioration of the facet joints that connect vertebrae. As the facet joints become arthritic due to this deterioration, they enlarge in an attempt to maintain stability of the spine. As the two vertebral segments adjoining the spinal canal slide past each other, the spinal canal narrows in size. The combination of spinal canal narrowing and enlargement of the facet joints produces the characteristic nerve compression problems found in degenerative spondylolisthesis. In degenerative adult spondylolisthesis, the most common forward slippage is of the L4 vertebra over L5 vertebra.
There are several different types of spondylolisthesis with the most common being congenital spondylolisthesis, isthmic spondylolisthesis and degenerative spondylolisthesis. Less common forms of this condition include traumatic, pathological and post-surgical spondylolisthesis.
Men are more likely to develop spondylolisthesis than women, as well as people who are active in physical activities like gymnastics, weightlifting and football. Some children under the age of five may also be pre-disposed to the condition. However, it is more common among children in the 7 to 10 year range. Some types of spondylolisthesis can be worsened from back surgery if the slippage becomes worse.
Risk factors include family history of back problems, chronic hypertension, or repetitive trauma to the lumbar spine. If you have had back surgery in the past, your risk of developing this condition also significantly increases.
At the Bonati Spine Institute, we aim to help our patients relieve their pain and treat spinal conditions through minimally invasive spine surgery. Dr. Bonati is one of the first arthroscopic spinal surgeons in the U.S. and his procedures have an over 94% patient satisfaction rate. He holds several patents relating to arthroscopic laser spine surgery, as well FDA approval for the use of the Holmium YAG laser on the spine. For more information, contact us at the Bonati Spine Institute today.