What is Spondylolisthesis?

Spondylolisthesis is a spinal condition characterised by the displacement of one vertebral bone over another. It can lead to pain and discomfort, varying in severity. This condition manifests in several types:

  • Degenerative Spondylolisthesis: Predominantly found in individuals over 50, this type arises from spinal wear and tear. As facet joints and intervertebral discs degrade, they lead to spinal instability.
  • Isthmic Spondylolisthesis: Typically seen in younger individuals, this form results from a defect in the vertebral structure's pars interarticularis.
  • Traumatic Spondylolisthesis: Directly linked to an accident or traumatic event.
  • Dysplastic Spondylolisthesis: A congenital issue where the posterior spinal joint's structure is abnormally formed.

Recognising the Symptoms

Spondylolisthesis symptoms can range from mild discomfort to severe pain:

  • Varying degrees of back or hip pain, often radiating down the leg.
  • Numbness, weakness, or both.
  • Pain after walking short distances, leading to frequent stops (claudication).
  • In some cases, challenges in controlling urination or bowel movements.

Diagnosing Spondylolisthesis

To diagnose this condition, the following investigations are typically conducted:

  • Plain X-ray, Motion View: The flexion-extension view helps assess spinal stability.
  • Magnetic Resonance Imaging (MRI): This is crucial for evaluating nerve compression's location, pathology, and severity.

Treatment Approaches

Treatment varies based on symptom severity:

For Mild Symptoms:

  • Lifestyle adjustments like avoiding heavy lifting and maintaining a healthy weight.
  • Strengthening the back and core muscles.
  • Medication.
  • Physical therapy.

For Severe Symptoms:

Surgery is often recommended for those with intense back or leg pain, or limited mobility. Surgical options depend on individual needs:

  • Stabilisation Surgery: Involves inserting a spinal implant to stabilise the spine and remove tissue and bone causing nerve compression, suitable for severe back pain or spinal instability.
  • Decompression Surgery: This involves removing tissue and bone compressing the spinal nerve. Modern techniques like microscopic or endoscopic surgery require a small incision, resulting in minimal injury, shorter hospital stays, and quicker recovery. Ideal for patients with primary leg pain due to nerve compression and no significant spinal instability.