Symptoms & Diagnoses of Spondylolisthesis
If you have spondylolisthesis, you may experience symptoms such as axial spine back in the neck and lower back, along with nerve pain in the arms, hands, legs, and feet. Grades are used to classify the condition and determine the necessary form of treatment with a grade 1 spondylolisthesis diagnosis signifying the least amount of slippage and a grade 5 representing 100 percent slippage. The less slippage there is, the less likely that the associated symptoms will become debilitating. However, even a minor displacement of a vertebra can cause nerve compression and chronic pain.
Symptoms might be experienced at the actual site of the spondylolisthesis or they can develop in an apparently unrelated area of the body. Pain and stiffness are most common at the site of the vertebral slippage, but if a displaced vertebra makes contact with or compresses a nearby nerve root, a set of neurological symptoms known as radiculopathy could be produced. Radiculopathy is characterized by radiating pain, tingling, numbness and weakness or loss of function in the group of muscles that are impacted by the compressed nerve root. The areas affected by nerve compression symptoms will depend on the location of the vertebral slippage.
Vertebral displacement in the lower back could lead to symptoms that are felt in the buttocks, legs, feet, and toes, while spondylolisthesis in the cervical (upper) region can affect the shoulders, arms, hands, and fingers. Regardless of its location, the condition can also lead to spinal cord compression, which could result in myelopathy. As a result, severe loss of muscular function or even paralysis in the lower body can occur.
Spondylolisthesis Treatment
Treatment prescribed for spondylolisthesis varies. To recommend a treatment plan, your doctor will assess the severity of your condition and the symptoms it is causing, as well as your overall health and medical history. The slippage that coincides with spondylolisthesis can result in stresses on tissues and impact to the delicate neural structures, which may be treated by a variety of methods, including:
- Medications. Anti-inflammatory drugs and pain medications can both be very helpful in the management of spondylolisthesis symptoms. Patients have several over-the-counter options, such as ibuprofen and acetaminophen, or they may request a stronger prescription if over-the-counter medications are not effective.
- Epidural spinal injections. In addition to oral medications, injected medications can also help minimize pain and inflammation caused by spondylolisthesis. Injections can be given individually or as a series, although there is typically a limit on the number of these treatments a patient can receive over the span of a year. Nerve block injections can also be administered to temporarily numb the nerves that are transmitting the pain signals.
- Physical therapy. Targeted exercises can be highly beneficial for patients with spondylolisthesis. A physical therapist can recommend a series of strengthening exercises, muscle stretches and balance-enhancing techniques to minimize back pain and other spondylolisthesis symptoms while helping you build up muscle mass and increase flexibility in the body.
- Low-impact exercise. Exercises such as walking or swimming as well as using a stationary bike or elliptical machine can help improve circulation and expand your range of motion. However, you should be careful to avoid harsh motions or movements that impact the spine, such as running or contact sports, which can make spondylolisthesis symptoms worsen.
- Alternative care. Although the following options are less traditional than medications and exercise, therapies such as acupuncture, yoga, Pilates and chiropractic adjustments can be helpful in the management of spondylolisthesis pain.
Most patients are instructed to use these therapies for several months, testing various combinations of conservative treatments to find an effective routine. This can take a bit of trial and error, although you should be able to develop a spondylolisthesis management plan with the assistance of your doctor.
However, if conservative treatments do not produce the desired results, your doctor may eventually recommend seeing if you are a candidate for surgery to help you obtain more meaningful symptom relief, such as the minimally invasive procedures at Laser Spine Institute.
Surgical Options for Spondylolisthesis
If conservative methods fail and surgery becomes a consideration, you may have several options to explore. Traditional open back surgery may be a treatment option for nerve compression, although minimally invasive spine surgery may offer more benefits, such as no lengthy recovery as well as lower complication and infection rates.^
Our board-certified surgeons+ perform several minimally invasive decompression spine surgeries that may be effective for patients with spondylolisthesis and other degenerative spine conditions. For instance, a patient may consider the following surgeries to treat nerve compression in the spine:
- Foraminotomy. During this procedure, a surgeon removes bone matter and tissues that are compressing a nerve in the spinal canal.
- Laminotomy. During this procedure, a surgeon removes part of the lamina, which is the arch that goes over the top of the spinal canal that helps relieve spinal cord compression.
- Discectomy. During this procedure, a surgeon removes herniated or bulging disc material that is pressing on the spinal cord or nerve root. This procedure is often combined with a stabilization surgery, which replaces a damaged disc with a bone graft, to treat spondylolisthesis.
- Facet thermal ablation. During this procedure, a surgeon numbs the nerve ending and cleans a facet joint to reduce pain and other symptoms.
