Spondylolisthesis

I know I do a lot on arachnoiditis but today I thought I would do some more on Spondylolisthesis, after all had I never been diagnosed I would most likely not have ended up with the arachnoiditis.

Spondylolisthesis

Spondylolisthesis occurs when one vertebra slips forward over the vertebra below. This condition can be congenital (present at birth) or develop during childhood or adulthood. In adults it is most commonly due to degeneration (wear and tear) of the discs and ligaments that bind and support the spine. As the vertebral components degenerate the spine’s integrity is compromised. A gradual deformity of the lower spine will happen as well as a narrowing of the vertebral canal. This can often be associated with pain. The most common area for this to occur is either L5-S1 (which can result in isthmic spondylolisthesis) or L4-L5 (which can result in particular for degenerative spondylolisthesis).

Approximately 80% of the people never even know they have a problem.
Five to six percent of males and two to three percent of females have spondylolisthesis.
Congenital (dysplastic) Spondylolisthesis

This is commonly seen in women. The dysplastic sacral facet joints allow forward translation of one vertebra relative to another This is more commonly seen in women. Symptoms usually occur during a growth spurt. It accounts for 14 to 21 percent of all spondylolisthesis cases. In these cases there is usually no defect in the pars interarticularis.
Isthmic Spondylolisthesis

Adolescents (10 - 15) who participate in activities such as gymnastics, football, soccer, weight lifting and diving or any activity or sport that hyperextend their back or develop a stress fracture of the pars interarticularis (The pars interarticularis is the part of the vertebra which is between the superior and inferior facets). Generally the adolescent is pain free, however if the L5 nerve root is irritated in L5-S1 isthic spondylolisthesis it can cause pain in the calf, anterior thigh, buttocks and the top of the foot.

Degenerative Spondylolisthesis

Degenerative Spondylolisthesis is by far the most common especially for women fifty years of age and older. When the lumbar vertebrae (L4-L5) slip it can narrow the spinal canal and place pressure on the nearby nerve roots, leading to pain and other symptoms.
Traumatic Spondylolisthesis

This category of spondylolisthesis imitates the type of injury associated with hanging because there is a fracture in the cervical spine. The primary causes include motor vehicle accidents, falls or other injuries leading to hyperextension or vertical compression of the neck. The injury is unstable but serious neurologic damage is not common.
Pathological Spondylolisthesis

This may be the result of destruction of the posterior aspect of the spine through either a tumor or infection of the bone, or severe osteoporosis. The disruption of the bone allows the slippage. This is one of the less common causes of spondylolisthesis.

Postsurgical:

Postsurgical spondylolisthesis is seen in a small percentage of patients who undergo decompressive laminectomy for spinal stenosis.

Treatment:

After being diagnosed with spondylolisthesis less evasive treatments will be tried first. Anti inflammatory medications to help reduce swelling and analgesics to control the pain may be tried. Physical therapy and exercise may also help the back.
Take care of yourself.

Disclaimer:

This information is for general information and understanding only. Please consult your physician and/or health care provide for specific information about your condition. Every effort has been to provide accurate, up-to-date information. However, the medical knowledge base is dynamic and errors can occur. By using the information contained herein, the viewer willingly assumes all risks in connection with such use.

My spondy was at the L5/S1 and was self induced. I was the head brewer in a small brewery (yes, I know an awesome job to have) and we did a lot of manual kegging. A full keg can easily weigh close to 170lbs and on a kegging day you will move probably 40-50 back and forth and up and down. While we had a keg jack to lift them up higher, to get them on the jack you had to lift them up 3-4 inches. Anyway, after 5 years of it one day my back told me to piss off.

The pain started like a pulled muscle but after a few days that turned to a burning sensation in my lower back and down my left leg. My doctor ordered a set of x-rays to look for sciatica and instead we came back with a grade 1 spondylolisthesis.

Long story short, I ended up having surgery about 9 months after the original diagnoses and not showing any signs of the pain ending through physical therapy. It also did not help that my doc told me to keep on working.

Surgery consisted of L5/S1 fusion and a laminectomy topped off with hardware (2 rods and 4 screws) installed for stability.

Surgery went great and things were on track for me to get back to work when I started having the pain again. We treated it like a pinched nerve for a bit but when the pain did not go away we did an MRI to see what was happening. Turns out I am one of those lucky people!!! They found that I had developed not only adhesive arachnoiditis but I also had new degeneration at the L3 & L4 which means as they deteriorate I will be facing down new pain and possibly another surgery to stabilize those vertebra.