Spondylolisthesis: symptoms, causes and how to treat it

Definition of spondylolisthesis

What is spondylolisthesis?

Spondylolisthesis or spondylolisthesis is a condition where the spine shifts from where it should be. The word "spondylolisthesis" itself comes from Greek; spondylos means spine and listhesis means "shifted".

So, the spine slides out of place into the position of the bones underneath it. This displacement of the spine from its position causes pressure on the nerves, which can cause excruciating pain.

This spinal disorder can also occur due to spondylolysis that is not handled properly, so that the spine becomes weak and cannot maintain its position and eventually shifts.

Reporting from the Cleveland Clinic page, spondylolisthesis is divided into several types, namely:

• Congenital spondylolisthesis

This type occurs when the baby's spine is not completely formed during the womb. This condition makes the baby's spine shift at a later date.

• Istmic spondylolisthesis

This type occurs as a result of a person having previous spondylolysis. When there is a fracture, the spine will weaken and can shift at any time.

• Degenerative spondylolisthesis

This type occurs generally in the elderly (elderly) because aging makes the discs that protect the spine lose water so that the spine can slide out of place.

In addition, there are also types of spinal displacement that are quite rare, including due to injury (traumatic), the presence of osteoporosis or tumor (pathological), and due to surgical operations on the spine.

How common is this disease?

Spondylolisthesis or spondylolisthesis is a spinal disorder that can affect anyone, from children, adolescents, to adults.

In children and adolescents, spinal displacement usually occurs during periods of bone growth. While in adults, it usually attacks the elderly due to aging factors.

Signs & symptoms of spondylolisthesis

In most cases, spondylolisthesis causes no symptoms. However, it is not uncommon for people with spondylolisthesis to experience symptoms, such as:

• Lower back pain, such as being pinched or pricked by a needle. It usually gets worse when you are actively moving or when you stand up. The pain will lessen when you rest on your back.
• Numbness or tingling from the lower back spreading to the legs. This symptom arises due to the presence of the spine pressing on the nerves.
• The hamstrings or muscles around the lower thigh tighten (tighten).
• The back feels stiff.
• When it is severe, sometimes this displaced spine can cause kyphosis. Kyphosis is the upper spine that curves excessively forward, resulting in a hunched posture.

Every person is very likely to feel the symptoms differently. The level of severity from one person to another is also different. Others feel other symptoms not mentioned above.

When to see a doctor?

If you experience the symptoms mentioned above, see a doctor immediately. Especially if back pain is persistent, or if you have health problems such as osteoporosis or spondylolysis.

Causes of spondylolisthesis

There are various causes of spondylolisthesis or spondylolisthesis that you may have, namely:

• Birth defects, because the spine is not fully formed while still in the womb. When you get older, the spine can shift due to certain activities, for example, gymnastics and weightlifting.
• The joints in the spine are worn or inflamed. This usually occurs frequently in the elderly or experiencing sudden trauma to the spine, for example a fracture.
• Spinal abnormalities that are usually caused by a tumor in the spine.

Risk factors for spondylolisthesis

The risk of spinal displacement varies from person to person. Here are some factors that can increase the risk of spondylolisthesis or spondylolisthesis, namely:

• Altet

Children, teenagers, or adults who work as athletes, such as gymnasts or soccer players, are more likely to experience this condition later in life.

• Genetics

People who have this type of istmic spondylolisthesis are born with a thinner portion of the spine, the pars interarticularis. This condition tends to cause fractures and eventually displacement.

• Age

As people age, the spine becomes weaker and more worn. This can cause the spine to shift, on average at over 50 years of age.

Even if you are at risk, it is not always possible to get this disease in the end. The reason is, the risk of shifting the spine may be decreased with precautions.

Diagnosis and treatment of spondylolisthesis

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

The symptoms caused by spondylolisthesis are almost the same as those of other bone or muscle problems or disorders. Therefore, to confirm the diagnosis of spondylolisthesis, the doctor will ask you to undergo a series of medical tests, such as:

Physical examination

The doctor will check your medical history and your family and ask about complaints about the symptoms you are experiencing. Then, the doctor will also ask about activities or professions undertaken, especially those that involve physical strength.

In addition, the physical examination also includes checking for symptoms directly, such as:

• Examination of the area causing pain.
• Limited range of motion.
• Frequent muscle weakness or spasms.
• Observation of your posture and gait. In some cases, there are patients who also have difficulty walking because the muscles around the thighs feel stiff.

Imaging test

This test is done to determine whether you have spondylolysis or spondylolisthesis. Some of the imaging tests that are usually performed include:

• X-ray: This test provides an overview of the bone density structure, fractures, or misalignment of the spine. If the results show a dilated pars interarticularis fracture and the spine is displaced forward, this could be an indication of spondylolisthesis.
• CT scan: Just like an X-ray, this medical test can also show the condition of the spine. It's just that, CT scans are usually much more detailed than ordinary X-rays.
• MRI: This medical test can provide an overview of damage to the intervertebralis between the vertebrae and the displacement of the spine from its actual position.

After a diagnostic test is done, the doctor will give you the spondylolisthesis values ​​that you have, such as:

• Low level (Level I and Level II): At this level, you do not need to have a surgical operation. Most of these cases occur in adolescents with istmic spondylolisthesis and in almost all cases of degenerative spondylolisthesis.
• High level (Grade III and Grade IV): At this stage, you will need surgical surgery because the pain is sometimes unbearable or goes away with regular medication.

What are the ways to treat spondylolisthesis?

Treatment of spondylolisthesis is usually determined based on the results of the assessment after diagnostic tests have been carried out. The following are ways to treat spondylolisthesis are:

Treatment without surgery

Initial treatments for non-surgical spinal displacement problems include:

• Resting the body from various activities, from bending, lifting, or doing certain sports movements.
• Take pain relievers, such as ibuprofen. If it is not effective, the doctor will increase the dose or replace it with a drug that has a stronger effect on pain relief.
• Get a corticosteroid injection around a compressed nerve or in the middle of the spine. This is done if you experience pain, numbness, or tingling in your legs.

Physical therapy

Physical therapy usually requires you to undergo physiotherapy. This therapy is done to increase the range of motion of the lower back and hamstrings. Usually, this therapy is a collection of stretching movements.

There are several stretching movements that you can do if you have spondylolisthesis, namely:

Movement to strengthen the abdominal muscles and muscles around the lumbar

Lie on your back with your knees bent and your feet touching the floor. Then, slightly lift your head followed by stretching your arms at your sides and slightly lifting them up in the air. Do this movement several times while catching your breath.

Pelvic tilt

Lie on your back with your back. Then, bend your knees with your feet flat on the floor while placing your hands in front of your chest. Then, lift your middle back slightly upward and hold it for a few seconds and back your back to the floor. Do this stretch several times while catching your breath.

Operation spondylolisthesis

Surgery may be recommended if previous treatments have not resolved symptoms of spinal displacement. However, the type of surgery chosen will be adjusted to the type of spondylolisthesis you have.

Generally, the surgery performed is to join the displaced bones together using additional instruments, such as screws, metal rods, pieces of bone from the closest other parts of the body. Metal screws and rods are left permanently attached.

In some cases, the disc between the vertebrae is removed and replaced with a bone graft to provide a barrier between the bones to keep them separate.

This spondylolisthesis treatment can generally relieve many of the symptoms of spondylolisthesis, especially pain and numbness in the legs. This is a major operation so it requires you to be hospitalized for a week and complete rest for months, about 2-6 weeks.

Although effective in relieving symptoms, this spondylolisthesis treatment can cause side effects including infection at the surgery site, blood clots in the legs, nerve damage, or paralysis.

Home care for spondylolisthesis

Apart from doctor's medication, spondylolisthesis also requires home care. His actions include adopting a healthier lifestyle, such as

• Follow the medication or treatment recommended by the doctor on a regular basis or on schedule.
• Eat foods that are healthy for bones, muscles and nerves, such as fruits, vegetables, fish, lean meats, and nuts.
• Adjusting activities to your body condition. For example, limiting strenuous activities, standing too long, and avoiding lifting heavy objects.
• Do exercises recommended by doctors and therapists on a regular basis to maintain bone flexibility and strength.

Prevention of spondylolisthesis

Several measures can be prevented from shifting the spine. Ways to prevent spondylolisthesis or spondylolisthesis include:

• Do regular exercise to strengthen the muscles around your back and stomach.
• Maintain a healthy weight because being overweight can put a lot of pressure on the lower back.
• Eat foods that are healthy for your bones, which contain vitamin D, phosphorus and calcium. You can get it from spinach, cow's milk or yogurt, nuts, and fish. In addition, balance it with regular consumption of fruits and vegetables.
• In people who are at risk, do not hesitate to further consult an orthopedic doctor, so that spondylolisthesis can be prevented.