Category: Spine | Author: Stefano Sinicropi | Date: December 12, 2017
Isthmic spondylolisthesis of the spine is a condition that occurs when one vertebral body slips forward onto the vertebrae below due to a small fracture in a piece of bone that connects the two joints on the backside of your spinal segment. The fractured bone is called the pars interarticularis, and an estimated 5-7 percent of the population have a fracture in this small bone, although about 80 percent will not experience any symptoms.
However, that still leaves a significant number of people with pain or symptoms from isthmic spondylolisthesis. Below, we take a closer look at what happens when the condition becomes symptomatic, and how it is treated.
Symptoms of Isthmic Spondylolisthesis
If you do begin to develop symptoms, here’s what you might experience:
- Low back pain that feels like a deep ache in your lumbar spine.
- Pain that radiates into your thighs, buttocks and even to your knees or feet.
- Pain that gets worse when walking or standing.
- Pain that goes away when seated or when lying down.
- Leg weakness or numbness
Symptoms generally are more severe depending on the grade of slippage. The higher the grade, the more the vertebra has slipped forward. Cases of isthmic spondylolisthesis are usually given a grade between 1 and 4, where Grade I involves 25 percent or less of the vertebral body slipping forward, Grade 2 has a slippage between 26 and 50 percent, Grade 3 has between 51 and 75 percent slippage, and Grade 4 has between 76 and 100 percent forward slippage. For patients with a more severe grade, they may also experience a hunched appearance and an inhibited gait.
Treating Isthmic Spondylolisthesis
The good thing about isthmic spondylolisthesis is that most cases can be treated with conservative treatment. Only about 1 in 5 people with symptoms need to undergo surgery to correct the issue. The most common conservative treatment techniques include medications to reduce inflammation in the area of the shifted vertebral segment, exercise, physical therapy, heat or ice packs, chiropractic manipulation or epidural steroid injections.
Should those remedies fail to correct the problem, surgery may be necessary. Surgery has a high rate of success, so most people who struggle to find relief through conservative care eventually find relief through an operation. One of the more common operations is a spinal fusion, which fuses the two vertebral segments together so that they can’t shift out of place. It does have a high rate of success, but since recovery takes a couple of months, most doctors don’t want to move forward with the procedure until the patient has tried different conservative methods for at least 4-6 months.
If the above symptoms sound familiar, or you just want a back surgeon to take a closer look at your spine, reach out to Dr. Sinicropi’s office today.