The term spondylolisthesis refers to a medical condition where one spinal bone (vertebra) has shifted forward relative to the one below. It is most common at the base of the spine, between the fifth lumbar vertebra and the top of the sacrum, the large triangular bone that connects the spine to the pelvis. There are four “grades” of spondylolisthesis, rated according to the degree of shift. Grade one is the least advanced, and grade four the most advanced. There are also two types of spondylolisthesis, describing how the condition began. Congenital (developmental) spondylolisthesis can be present at birth or result from a developmental issue during childhood, but typically does not get diagnosed until later in childhood, or even until adulthood. Acquired spondylolisthesis can result from a single large force being applied to the spine, as in anauto accident or falling injury, or from a series of repetitive forces being applied to the spine, as in gymnastics, weightlifting or football. It can also occur as a secondary effect of spinal degeneration, as the discs and support structures of the spine weaken and allow the gradual forward shift of the spine to occur.
It has been estimated that about 6% of the American population will be diagnosed with spondylolisthesis at some point in their lives. The most common form of spondylolisthesis is acquired grade two, which most commonly results from damage to a vertebral structure called the pars interarticularis, two bony knobs that serve to prevent forward movement of the vertebrae. When these structures are damaged due to severe or repetitive trauma, a shift of the vertebra can occur. Gymnasts, weight lifters, and football linemen are particularly prone to this condition. The condition affects both men and women, although the incidence in men is about twice as high. This is probably due to the tendency of men to engage in intense physical activity more consistently and often than women.
Many people can live with a low-grade spondylolisthesis their entire lives, and never experience any symptoms as a direct result. However, there are many symptoms that can result from this condition, including but not limited to: back pain, hip or buttock pain, sciatica, bowel or bladder dysfunction, tight or spastic muscles in the low back, hip or leg, and increased lumbar curvature, or “swayback”. Spondylolisthesis is identified easily with x-ray, but often times the condition goes misdiagnosed for years due to the symptoms being mild, and treatment plans focusing on symptom relief alone.
Treatment of spondylolisthesis varies depending upon the grade and type. A full review of the history as well as a complete physical assessment, including detailed x-rays, is required to make an accurate diagnosis. Surgery is sometimes required in more advanced acquired or congenital cases, but a more conservative approach is often sufficient to ease symptoms and restore full function. These treatment options include but are not limited to: chiropractic care, injection therapy, non-surgical spinal decompression, physical rehabilitation, core strengthening exercises, and pain coping skills training. At Lowcountry Wellness Center, our team of doctors will provide a complete review of your medical history as well as a comprehensive physical assessment. This will allow the doctors to create a treatment plan customized to your specific condition giving you the best chance for rapid and complete recovery. Call us at (843) 793-1353 to schedule your consultation appointment today!