Spondylolisthesis is a forward slip of one vertebra in the spine on the one below. This condition is graded from 1 to 4 depending on the degree of slip of the vertebra. A spondylolisthesis can be either congenital or degenerative.
The most common form of this condition results from a congenital defect to a part of the vertebra known as the pars interarticularis. The pars connects the front half of the vertebra (body) to the back half. Incomplete bony fusion of the pars during development of the spine allows the body of the vertebra to slip forward. Mostly this condition goes unnoticed and asymptomatic until well into the adult years. It is often discovered after a simple strain injury occurs that the person struggles to fully recover from.
As a result of severe degenerative change to the lumbar discs and facet joints, the vertebra may slip forward. In this instance there is no defect in the pars interarticularis. This is a disease of the older spine.
Lower grade spondylolisthesis generally presents as back ache. It is usually aggravated by sporting activities and walking. It tends to settle with rest, sitting and flexing the spine. More severe grades will often result in pain, pins and needles and weakness in the legs. This is caused by compression and irritation of the nerves exiting the spinal canal as a result of the forward slip.
Depending on the degree of slip and the symptoms experienced, the management can vary. Conservative management centres around specific core stability exercises, to take the load off, and improve the segmental stability of the affected level. In the event of failure of conservative management, a surgical solution may be required. Premium Physiotherapy can organise a consultation with one of our affiliated spinal surgeons if necessary.