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Spondylolisthesis


Overview
Spondylolisthesis occurs when one vertebra slips forward in relation to an adjacent vertebra.

Causes
Spondylolisthesis can be caused by degeneration, trauma or congenital defects.

Symptoms
Spondylolisthesis may cause pain arising from within the moving parts of the spine. The instability usually leads to growth of the facet joints, which compress the nerves also causing pain. For example, a pinched nerve can produce pain in the back, and sciatica or pain that radiates down to the foot. It can also cause numbness in the foot and weakness in the muscles supplied by the affected nerve.

Diagnosis
Your physician will take a history, perform a physical exam, and will likely request an X-ray. X-rays are often all that are needed to diagnose a pars defect or forward slip of a vertebra. Sometimes however, bone scans and CT scans are preferred.

Treatment Options
Treatment for spondylolisthesis is similar to treatment for other causes of mechanical and compressive back pain. Doctors may prescribe rest during the acute phase to help relieve symptoms. Special braces or casts may be used to help heal a stress fracture and to ease pain. Your doctor may also prescribe physical therapy and/or pain medication. Specific exercises are important for rehabilitation. If conservative treatments fail, your doctor may recommend surgery. Surgical treatment should relieve both mechanical and compressive pain as well as any pressure on spinal nerves. The surgical procedure for spondylolisthesis is known as decompressive laminectomy and fusion of the lumbar spine. The decompression will free up the affected nerves. The fusion is then performed to stabilize the segment.

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