Spondylolisthesis

Spondylolisthesis is a state in which one vertebrae slides on the surface of another vertebrae, in this case the upper vertebrae slides in comparison to the connecting vertebrae just below it, so we can say that in its core spondylolisthesis is an instability in a segment of the spine. When it occurs it damages and can produce degenerative changes on the intervertebral disc between the affected vertebrae.

Reasons why spondylolisthesis occurs are many: abnormalities of the vertebrae, both genetic or aquired; acute fractures of the spine, degenereative spine illnesses, osteoporosis, bone tumors, trauma which leads to the vertebrae slipping, etc.

There are 5 degrees of this condition and they are determined according to the length of the frontal shift of the vertebrae. Degree 1 and 2 can be treated by using conservative methods, but degrees 3, 4 or 5 require surgical treatment.

         ·         Degree 1: 0-25% of vertebral shift

·         Degree 2: 25-50% of vertebral shift

·         Degree 3: 50-75% of vertebral shift

·         Degree 4: iznad 75% of vertebral shift

·         Degree 5: 100% of vertebral shift – spondylolipthosis

Spondylolisthesis has specific symptoms which can often appear in adolescence during the phase of intensive growth. The intensity of symptoms can range from very low to very severe and painful which can only be relieved by complete rest or surgical treatment. Pain appears in the sacral region and spreads to the gluteal region and into one or both legs. Symptoms can be accompanied by neurological signs, such as a decrese in level of certain senses and reflexes, etc. It was noticed that the majority of patients have an increase in the range of the lumbar lordosis and during treatment special attention is put on controlling and preventing of lumbar lordosis increasing even more above the normal range.

It is of the utmost importance that patients with spondylolisthesis get proper education in order to treat this condition effectively and not worsen it. Abdominal muscles strenghtening, posture correction and general back and spine muscle strenghtening with a highlight on paravertebral musculature along with stretching exercises for shortened and tense muscles and fascia must be implemented in rehabilitaion of spondylolisthesis. Orthosis can be used if needed and education on proper movement patterns during daily activities like lifting and carrying of heavy objects, sitting down, lying down, standing up, etc. is highly advised.