Lumbar spondylolisthesis - a common diseaseof the spine !
‘Spondylolisthesis’ is a Latin term meaning ‘slipped vertebral body’, and happens when one vertebral body slips forward over the one below it. This happens due to the general aging process in which the bones, joints and ligaments in the spine become weak and therefore unable to hold the spine in proper alignment. It leads to back pain and at times leg pain when the nerve root gets compressed.
Degenerative spondylolisthesis is common in people over the age of 50 and almost equally affects both men and women. The slipping of L5 over the S1 vertebral body usually happens, though we do see a lot of cases with L4 L5 listhesis. There is a defect in the neural arch especially in the ‘pars interarticularis’ where there is a fatigue (lytic) fracture.
Many patients with this condition are asymptomatic, and some do develop back pain. With worsening of this degenerative disease of the spinal column, symptoms such as pain & numbness in the legs start appearing. This is due to the stretching or compression of the nerve roots as they emerge from the neural foraminae. A simple X ray of the lumbosacral spine will tell us the degree of the spondylolisthesis which ranges from grade Ito grade IV. CT and MRI of the spine will give more details on the spine column and if there are any nerve compression associated with this condition.
Asymptomatic patients and those with mild back pain can be treated with conservative means. Some need just analgesics a-rid—physiotherapy for the para spinal muscles so that the disease process does not advance. Patients with progressive disease leading to severe back pain with or without lower limb pain/numbness will require spine stabilisation (fusion) procedures. Not only this surgical procedure relieves the compression on the nerves, it also helps to align the spine and prevent further vertebral body slippage. Following surgical fusion most of the patients are back to their routine lifestyle, comfortable and free of symptoms. Prompt treatment of this common condition carries a good prognosis !