Spondylolisthesis Treatment


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    • Spondylolisthesis is a spinal condition that causes lower back pain. It occurs when one of your vertebrae, the bones of your spine, slips out of place onto the vertebra below it. Most of the time, nonsurgical treatment can relieve your symptoms. If you have severe spondylolisthesis, surgery is successful in most cases.
    • Spondylolisthesis and spondylolysis occur in about 4% to 6% of the adult population. It’s possible to live with spondylolisthesis for years and not know it, since you may not have symptoms.
    • Spondylolysis: This spine defect is a stress fractures or crack in spine bones. It’s common in young athletes.
    • Spondylolisthesis: This condition is when a vertebra slips out of place, resting on the bone below it. Spondylolysis may cause spondylolisthesis when a stress fracture causes the slipping. Or the vertebra may slip out of place due to a degenerative condition. The disks between vertebrae and the facet joints (the two back parts of each vertebrae that link the vertebrae together) can wear down. Bone of the facet joints actually grows back and overgrows, causing an uneven and unstable surface area, which makes the vertebrae less able to stay in place. No matter what the cause, when the vertebra slips out of place, it puts pressure on the bone below it. Most cases of spondylolisthesis do not cause symptoms. If you feel leg pain, it can also be caused by compression or a "pinching" of the nerve roots that exit the spinal canal (the tunnel created by the interlocking vertebrae of the spine). The compression or pinching is due to the vertebrae slipping out of position and narrowing the needed space for the nerves.

    What are the types of spondylolisthesis?

    Types of spondylolisthesis include:
    • Congenital spondylolisthesis occurs when a baby’s spine doesn’t form the way it should before birth. The misaligned vertebrae put the person at risk for slippage later in life.
    • Isthmic spondylolisthesis happens as a result of spondylolysis. The crack or fracture weakens the bone.
    • Degenerative spondylolisthesis, the most common type, happens due to aging. Over time, the disks that cushion the vertebrae lose water. As the disks thin, they are more likely to slip out of place.

    Will I need surgery for spondylolisthesis?

    Your healthcare provider will start with nonsurgical options, such as rest and physical therapy. These treatments often relieve symptoms. Your healthcare provider may recommend surgery if you:

    • Have high-grade spondylolisthesis.
    • Experience severe pain.
    • Tried nonsurgical treatments but still have symptoms.


    What are the symptoms of spondylolisthesis?

    You may not experience any symptoms of spondylolisthesis. Some people have the condition and don’t even know it. If you do have symptoms, lower back pain is typically the main one. The pain may extend to the buttocks and down the thighs. You may also experience:

    • Muscle spasms in the hamstring (muscles in the back of the thighs).
    • Back stiffness.
    • Difficulty walking or standing for long periods.
    • Pain when bending over.
    • Numbness, weakness or tingling in the foot.

    What happens during surgery for spondylolisthesis?

    • Surgery for back pain due to spondylolisthesis typically involves spinal decompression, with or without fusion. Decompression alone is almost never done in isthmic spondylolisthesis. Studies show fusion with decompression may give better outcome than decompression alone. During a decompression surgery, your surgeon removes bone and disk from the spine. This procedure gives the nerves space inside the spinal canal, relieving pain.
    • For a fusion surgery, your surgeon fuses (connects) the two affected vertebrae. As they heal, they form into one bone, eliminating movement between the two vertebrae. You may experience some limited spinal flexibility as a result of the surgery.

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