What Is Spondylolisthesis?
Spondylolisthesis means that one vertebra has slipped forward upon the vertebra below it.
2 Most Common Types of Spondylolisthesis
There are 6 types of spondylolisthesis. We will discuss two of the most common types we see. The first type develops when you are young and is called isthmic spondylolisthesis. The second type develops when you are older and is called degenerative spondylolisthesis.
Isthmic Spondylolisthesis (Young People)
This occurs in approximately 6% of the population. These develop around age 7. Symptoms typically do not start until the teenage or early adult years. We see them most frequently at the L5 vertebra. Athletes exposed to hyperextension motions or repetitive stress to an area of weakened bone can cause a stress fracture. If you have this type of spondylo and you are over 40 before you develop symptoms, then it is rarely the sole cause of your pain.
Degenerative Spondylolisthesis (Older People)
This occurs in people who are generally over 50 years old. It most commonly is seen at L4 and then at L3 vertebral level. It occurs up to 6 times more in women. The disc degenerates and the joints become arthritic and unstable. This allows the vertebra to slip forward upon the one below.
Common Signs and Symptoms
- Pain may stay in the back, but it can lead to radiating pain down the leg or weakness.
- Difficulty walking or standing for a long time.
- Pain with bending, lifting, or twisting.
How is it Diagnosed?
Spondylolisthesis can be seen on x-ray. Sometimes further evaluation is done with MRI.
Stability is the Key
The degree of forward slippage varies from patient to patient. The degree of slippage is not nearly as important as determining the degree stability. We may request special x-rays to determine the amount of back-and-forth movement of the vertebra. The more stable it is, the less symptoms a patient will have, and the better response they will have with conservative care.
We use Cox flexion distraction manipulation to decompress the spine and restore more normal spine function. This can reduce stress on the spondylo.
Bracing may be necessary for a short period of time.
Most people with spondylo’s have tight hamstrings, which need to be stretched.
Avoid lumbar extension exercises. Extension creates jamming and compression. We train you on flexion exercises. A 3-year study published in the Archives of Physical Medicine and Rehabilitation found that the group who did extension exercises had an overall recovery rate of 0% (no improvement in their pain or ability to work.) The group who did flexion exercises had an overall recovery rate of 62%.
Surgery may be necessary in cases where there is more severe instability.
THE MOST ADVANCED COX TABLE EVER DESIGNED
We are pleased to announce the addition of the most advanced Cox decompression table ever designed, to our office! The Cox 8 Force Table is a state of the art instrument. Built in sensors send data to a computer, giving the doctor real-time information about the amount of decompressive force being applied.
Discuss your case with the doctor to see if you are a candidate for treatment.
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Overland Park, KS 66210
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