Spondylolisthesis & Spondylolysis

Spondylolisthesis, (pronounced SPON-dill-oh-lis-THEE-sis) and spondylolysis (pronounced SPON-dee-low-LYE-sis are common causes of low back pain. Spondylolisthesis refers to one vertabra slipping over another in the front of the spine. Spondylolysis is when there is a separation of the small bony arch in the back of the spine located between the facet joints; this is called the pars interarticularis. In more common terms, spondylolisthesis is a stress factor that weakens the bones causing them to lose proper positioned and spondylolysis is a stress fracture in the bones of the spinal column.

Spondylolisthesis & Spondylolysis Similarities and Differences

Spondylolysis is considered the most common reason for lower back pain among young athletes. In fact, research shows that only 3 to 6 percent of the entire population are affected. X-rays are the easiest way to determine that the injured individual has this condition. Spondylolysis generally affects the fifth lumbar vertebra (sometimes the fourth).

Spondylolisthesis more commonly occurs in adolescents than adults. This condition can develop anywhere along the spine however the lower back is the mostly affected. In severe cases, the vertebral bones may press on nerves causing intense pain.

Causes

These spinal conditions are believed to develop as a result of overuse or it can even be hereditary. From a hereditary perspective, research seems to indicate that spondylolysis is more likely to occur in those who were born with thin vertebral bones. Add to this certain sports and activities that place stress on the lower back means the chances of being inflicted with spondylolysis increases.

Sports such as gymnastics, football and weight-lifting can contribute to spondylolysis and spondylolisthesis formation. Individuals who experienced significant periods of rapid growth in their life may also be at risk for vertebral slippage.

Symptoms

It may sound odd but a person may have one of these conditions and not experience any symptoms. When they do occur, the pain is described like having a muscle strain stretch across the lower back. An attempt to continue in activities that require use of the lower back can worsen spondylolysis back pain.

Spondylolisthesis can affect how a person walks and their posture because this may narrow the spinal canal which causes nerve compression. The individual may also experience an upper back ache and spasms that tighten the hamstring muscles.

Diagnosis

Diagnosis of spondylolysis and spondylolisthesis is dependent on a qualified health professional looking at a set of X-rays, a CAT scan, or an MRI scan. In most cases, these conditions are easily seen on an X-ray of the lumbar region.

Treatment

Treatment goals for spondylolysis and spondylolisthesis are simple:

• Pain reduction.
• Allow the fracture to heal.
• Return the patient to their daily activities.

The great news is that treatment is almost always nonsurgical. Most patients with spondylolysis and low-grade spondylolisthesis will greatly improve with nonsurgical treatment.

Nonsurgical treatment may include:

• rest;
• nonsteroidal anti-inflammatory drugs;
• physical therapy; and
• bracing

Improving Stability and Control

One chiropractic approach to the treatment of spondylolisthesis is to strengthen and re-coordinate the deep support muscles of the lower back area. An attempt is made to improve the dynamic stability and control of the spine. The patient may learn spinal stabilization exercises to train the muscles in order to gain stability and control.

Postural Correction

Over time many spondylolisthesis patients may develop postural asymmetries. One important factor in treatment is the correction of any loss of the normal upright alignment of the spine and pelvis. Patients will learn corrective exercises specific for the postural imbalances they have developed.

Orthotics

Depending on the individual’s condition, long-term support of the spine may be required by using custom-made orthotics. A common factor that occurs in many of these patients is that they have low or absent arches in their feet making additional support necessary.

Surgery

Surgery is required only if all other treatment options fail. Nerves that exit the spine must be freed of all pressure by a laminectomy.  However, this is a ‘last resort’ option and only in dire situations. Most patients find relief through regular chiropractic care.

For more information on spondylolisthesis and Spondylolysis feel free to call our office during regular business hours and one of our associates will be please to speak with you. Established in 2007 by Dr. Behfar Sanjari, Chiro-Med Rehab Centre has been committed to providing quality health care services to the Greater Toronto Area for over half a decade. We have clinics located in Richmond Hill and Newmarket, visit Chiro-Med online or call 905-918-0419 or 905-235-2620 for more information.