Spondylolisthesis
Spondylolisthesis is the medical term used to describe the forward slippage of one spine bone on another.
Spondylolisthesis is a common condition to require surgery. Fortunately, the results are usually very good. Children with spondylolysis/spondylolisthesis rarely require surgery unless the slippage is severe.
Spondylolisthesis
Diagnosis
The diagnosis of spondylolysis and/or spondylolisthesis may be suspected, particularly if the aforementioned physical findings are present. An X-ray or CT scan is required to confirm the diagnosis, as well as to grade the severity of the condition.
Treatment Options
Conservative Treatments
The treatment of adult patients with spondylolisthesis depends on the severity of the pain, nerve compression and slippage. Some patients are recommended for conservative treatment initially unless there is a severe neurologic deficit such as leg weakness and numbness. Physical therapy and oral medications are frequently prescribed. Epidural steroid injections and/or nerve root blocks may also be utilized for severe pain or moderate pain that is no longer responding to other conservative measures.
Surgical Treatments
Patients who do not benefit from these conservative measures are usually candidates for surgical intervention. The recommended surgery for adults with spondylolysis and/or spondylolisthesis who have failed nonoperative measures is spinal fusion. The goal of surgery is to stabilize the levels of the spine that are “slipping” by placing bone graft and metal rods and screws. Adult patients with significant stenosis generally require laminectomy and decompression, whereas children do not. The instrumentation fixes and holds the bones in place immediately, while the bone graft fuses the unstable spine bones together. After the fusion surgery is performed, it takes approximately three to eight months for the bones to solidly mend together.
