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Spondylolisthesis is a condition in which one vertebra slips forward and onto the one beneath it. Spondylolisthesis mostly affects the low back (lumbar spine) because that part of your spine bears a lot of weight and absorbs a lot of directional pressures.

Spondylolisthesis may be classified into different grades depending on how far forward the vertebra has slipped:

  • Grade 1 or type 1 spondylolisthesis (also called dysplastic or congenital spondylolisthesis i.e. present at birth)
  • Grade 2 or type 2 spondylolisthesis (also called isthmic spondylolisthesis and is the most common kind of spondylolisthesis)
  • Grade 3 or type 3 spondylolisthesis (as a result of aging which causes the spine to degenerate or wear out)
  • Grade 4 or type 4 spondylolisthesis (involves a fracture)
  • Grade 5 or type 5 spondylolisthesis (caused by tumors on the vertebra)
  • Grade 6 or type 6 spondylolisthesis (also called iatrogenic spondylolisthesis and is a result of a spine surgery like laminectomy that caused your vertebra to slip forward)


Causes of spondylolisthesis

  • Birth defect: In children, spondylolisthesis usually occurs between the fifth bone in the lower back (lumbar vertebra) and the first bone in the sacrum area. It is often due to a birth defect in that area of the spine.
  • Degenerative disease: In adults, the most common cause is degenerative disease (such as arthritis). The slip usually occurs between the fourth and fifth lumbar vertebrae.
  • Stress fractures (commonly seen in gymnasts) and traumatic fractures: Spondylolisthesis may occasionally occur because of bone diseases.
  • Spondylolysis (a defect or fracture in the pars interarticularis)
  • Tumors
  • Surgery


Risk factors of spondylolisthesis

  • Movements that put substantial stress on the spine
  • Repeated excessive strains and stress
  • Gymnasts, linemen in football, and weight lifters all put significant pressure and weight on their low backs and are therefore more susceptible to spondylolisthesis.


Symptoms of spondylolisthesis

Some of the symptoms that often accompany spondylolisthesis are:

  • Increased lordosis (i.e., swayback or saddle back)
  • Lower back pain, especially after exercise
  • Localized tenderness over the spine just above the pelvis
  • Neurological damage (leg weakness or changes in sensation) may cause pain in the legs and thighs
  • Pain in the buttocks
  • Reduced ability to control bowel and bladder functions
  • Tight hamstrings
  • Stiffness in back
  • Kyphosis (roundback) in later stages as the upper spine falls off the lower spine

However, it should be noted that many people with a spondylolisthesis will have no symptoms, and will only become aware of the problem when it is revealed on an X-ray for a different problem.


Treatment options

Treatment varies depending on the severity of the spondylolisthesis.

  • Conservative treatment: Most patients require only strengthening and stretching exercises combined with activity modification (avoiding hyperextension of the back and contact sports). Some practitioners also use a rigid brace.
  • Surgical treatment: For cases with severe pain not responding to therapy, if the slip is severe, or there are neurologic changes, surgical intervention may be necessary. The slipping vertebra is surgically fused using the spinal fusion surgery. A brace or body cast may be used after surgery. In some cases, fusion with decompression may be used.


Medical tourism and spondylolisthesis surgery abroad

With any kind of surgical treatment, the cost of the surgery is an important consideration if you do not carry sufficient health insurance. At our partner spine hospitals abroad (like in India, Singapore, Spain, Turkey, Costa Rica, Mexico, etc.), spinal procedures are offered at considerably lower prices compared to the cost of treatment at spine hospitals in the United States. And yet, the quality of care (pre-surgery, surgery, post-surgery, physical therapy and follow-up) is comparable or even superior to what is available in America. Healthbase arranges spine operations for spondylolisthesis overseas for 60% to 90% less price than in the US. Apply for a FREE quote for spondylolisthesis surgery abroad.


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