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Spondylolisthesis

This is a big word that is hard to pronounce, so let me break it down for you. Spondylo is a Greek word for spine and listhesis means to slip. This is not a slipped disc, rather it refers to one vertebral body slipping forward on another so that two segments of the spine are out of alignment.

About

This occurs primarily under two circumstances.

  • Most commonly it occurs in patients beyond middle age and is referred to as degenerative spondylolisthesis. This is the result a combination of disc degeneration and facet arthritis.
  • The other circumstance occurs much earlier in life, often starting in adolescence, and becoming symptomatic in early adulthood. This is referred to as spondylolytic (or Isthmic) spondylolisthesis. You can see from the first term that it refers to the spine but the second part of that word, -lysis, means “to cut”. This really refers to a bony defect in the back of your spine that makes the spine a little bit unstable and allows one bone to slip forward on the other.

In both cases the result is the same. The symptoms usually always include back pain but often include leg pain that radiates to the foot (or both feet). Leg pain can actually be the predominant symptom and often leads to the first doctor visit. This is because leg pain, which is actually nerve pain, is harder to tolerate than back pain. This results from the bones being out of alignment which leads to pinching of nerves.

Treatment

We do have non-operative techniques to help with these problems but very often the best solution is surgery. Even if the non-operative means are successful the symptoms often return. The surgery for these problems includes Spinal Fusion and some type of laminectomy is usually needed. The term laminectomy can be broken down as well to help us understand what it means. Lami- refers to lamina, which is the bony covering on the back of the spine that covers the spinal canal and nerves while –ectomy means to remove something. For example an appendectomy is removal of the appendix. A laminectomy is used to tack the pressure of the nerves that may have been pinched by the misaligned or slipped bones. If you only have back pain and no leg pain then fusion alone may all that is needed.

Learn More About Spondylolisthesis