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Spondylolisthesis is the displacement of one vertebra from its normal position, often occurring at the lower end of the spinal cord. It is a condition that can affect your quality of life and become progressively painful if not treated early, as nerve compression can lead to chronic pain over time. However, if diagnosed early, it can be treated, and better outcomes can be achieved. In this blog, you’ll learn about the steps involved in the procedure for treating spondylolisthesis, including their advantages and the risks that may be involved.
In spondylolisthesis, the fractured pars interarticularis (pars) separates, thus allowing the slippage or forward displacement of the vertebrae immediately below it. In children and adolescents, it often occurs during growth spurts, i.e. rapid growth periods.
Spondylolisthesis is seen among 4% to 6% of children. Spondylolisthesis is graded depending on the extent of slippage seen to occur. A low-grade Spondylolisthesis is when less than 50% of the width of the fractured vertebra slips forward. High-grade Spondylolisthesis is when > 50% width of the fractured vertebrae has slipped forward on the vertebrae below. Isthmic is the most common form of spondylolisthesis, occurring at L5-S1. Significant pain is felt in high-grade Spondylolisthesis because of the nerve compression, and surgery may be required to relieve symptoms and avoid further deterioration.
Visit a top multispecialty hospital for spondylolisthesis treatment in Old Airport Road.
What are the Treatment Options for Spondylolisthesis?
For low-grade spondylolisthesis, associated with back pain and other symptoms, non-surgical treatment options are available.
Non-Surgical Treatment Options
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Rest
Avoiding activities that impart excessive stress on the lower back over time can help in relieving back pain and other symptoms. These activities may include sports activities etc.
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Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
NSAIDs like ibuprofen and naproxen are given to reduce swelling and manage back pain.
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Physical Therapy
Some exercises can help improve overall flexibility and strengthen the back and abdomen muscles.
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Bracing
A back brace may need to be worn for a specific period to achieve limited movement of the spine, allowing pars fracture to heal.
Over the course, doctors will require periodic X-rays to evaluate the changing position of vertebrae.
Surgical Treatment Options
In cases of high-grade slippage, surgical treatment is recommended after carefully diagnosing the condition. The spinal fusion between the 5th Lumbar vertebrae and the sacrum is often done to treat spondylolisthesis. It’s a procedure to relieve pressure on the compressed spinal nerve.
What is Spinal Fusion?
In spinal fusion, the slipped vertebrae are realigned to their proper position and joined to the vertebrae below with the help of metal rods and screws, and a bone graft is used to fill in the space.
In a spinal fusion, the following steps are involved:
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Preoperative Evaluation and Planning
The experts evaluate your medical history. It involves physical examination, running some blood tests, and imaging studies such as X-rays, CT scans, or MRIs to grade the condition as mild or severe and chart down the treatment plan and the surgical approach.
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Anaesthesia
The procedure is done under general anaesthesia to ensure a pain-free experience.
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Incision
An incision is made in the back to access the affected spinal area. However, the surgeon may also use a front approach depending on the case.
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Decompression
Once the access is made, any damaged or herniated disc material that compresses the nerve or spinal cord is removed.
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Bone Grafting
A bone graft is used for spinal fusion. Small pieces of bones are used to fill the spaces in between the impacted vertebrae. The primary aim of using bone graft is to stimulate bone healing. By increasing the production of bone, the vertebrae heal together into a solid bone. If required, the surgeon may sometimes use solid pieces to provide structural support to the vertebrae.
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Stabilisation/Immobilisation
Once the damaged tissue is removed, the surgeon uses rods or screws, and plates to stabilise it and prevent any future slippage.
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Closure
The surgeon closes the incision with sutures and staples once the site is stabilised. You will feel pain post-surgery, which is a natural part of healing. The doctors and nurses will try their best to reduce it and help recover from surgery.
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Medications
Pain medications are often prescribed for short-term pain relief, and nonsteroidal anti-inflammatory drugs (NSAIDs) are used.
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Rehabilitation
It takes months before the bone becomes solid. But your comfort level improves much faster. Properly aligning the fused spine is important during the healing period, and physical therapy is recommended 3- 6 weeks post-surgery.
What are the Advantages of Spinal Fusion?
Surgical procedures can significantly benefit patients with severe symptoms who don't respond to conservative treatment. These advantages include the following:
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Relief from pain and discomfort.
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Significant improvement in function and mobility.
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Faster recovery time via robotic surgery.
What are the Risks Involved in a Spinal Fusion?
Like all surgeries, this one also involves its risks. But the risks are minimal.
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Infection
Antibiotics are regularly advised to the patient Before, during, and post-surgery to lessen the chances of infection.
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Bleeding
There is an expected blood loss during the surgery. However, it's minimal.
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Nerve Damage
There is a chance of possible blood vessels or nerve injury during the procedure, but it's rare.
Consult a top spine specialist in Old Airport Road for diagnosis and treatment of Spondylolisthesis.
FAQs
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What are the many types of spondylolisthesis?
Spondylolisthesis is classified into five types: dysplastic, isthmic, degenerative, traumatic, and pathological. The underlying cause of the condition is used to classify each category.
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How is spondylolisthesis diagnosed?
Physical examination, imaging studies such as X-rays or MRI scans, and an evaluation of your symptoms and medical history are commonly used to diagnose spondylolisthesis.
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Is it possible to avoid spondylolisthesis?
While there is no sure way to prevent spondylolisthesis, several precautions can be followed to lessen the likelihood of acquiring the condition. These include keeping excellent posture, exercising and stretching regularly, and avoiding repetitive injuries to the spine.
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