How To Treat Spondylolisthesis? The Best Treatment For Mild and Severe Spondylolisthesis

Spondylolisthesis is a potentially debilitating spinal condition. Unfortunately, it can develop at any age and can be caused by a variety of factors. 

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When spondylolisthesis occurs, it means that one of the spinal bones, known as vertebrae, has slipped out of its normal position. The bone rests on the vertebra directly beneath it. 

Several possible treatment approaches exist for spondylolisthesis, most of which are non-surgical. However, in cases of severe spondylolisthesis, surgery is often required. 

This article will explore topics surrounding this spinal condition, including the best treatment options for spondylolisthesis. 

What Are The Symptoms of Spondylolisthesis?

Many spondylolisthesis cases are asymptomatic. However, patients with symptomatic spondylolisthesis may experience: 

  • Lower back pain and stiffness
  • Spasms in the hamstring muscles
  • Discomfort while walking or standing for extended periods
  • Neurological symptoms including numbness, tingling, and/or weakness in the foot

How Did I Get Spondylolisthesis?

One of the most common reasons why young people develop spondylolisthesis is a spinal birth defect. This is known as congenital spondylolisthesis.

With this condition, one of the areas of the spine that controls the motion of the vertebrae (known as articular processes) hasn’t developed properly. As a result, the affected vertebra slips forward onto the vertebra beneath it. 

Another key cause of spondylolisthesis is acute trauma to the spine. Though rare, spondylolisthesis can be caused by a fracture in the spinal segment due to direct trauma. 

In older individuals, spondylolisthesis often results from wear and tear on the spinal bones. Specifically, spondylolisthesis can result if osteoarthritis (also known as wear and tear arthritis) damages the cartilage in the facet joints of the spine.

How Do You Stabilize Spondylolisthesis?

The first step in recovering from spondylolisthesis is to stabilize the spine. There are a few non-surgical stabilization strategies that you can implement to alleviate pain and other symptoms. Spondylolisthesis exercises, in particular, are often helpful for strengthening the muscles that stabilize the spine. 

Some of the best exercises for spondylolisthesis include:

  • Knee To Chest

Start by lying on your back with bent knees and feet flat on the ground. Place your arms by your sides with the palms facing down. Then, while engaging your core, raise one knee to your chest, using your arms for added support. Hold for five seconds, then return to the starting position. 

Alternate legs, completing a few sets each morning and night.  

  • Pelvic Tilt

Start lying on your back with bent knees and feet flat on the floor. Engage your abdominal muscles while pulling the belly button toward the spine and pressing your lower back to the floor. Hold this position for 15 seconds, keeping your abs engaged. 

Repeat 5 to 10 times. 

  • Bird-Dog Exercise

Begin on your hands and knees. Engage your core and pick up one arm and the opposite leg. Stay in this position for 5 seconds before returning to the initial position. Then, repeat with the opposite arm and leg, completing 10 sets in total. 

Spondylolisthesis Exercises To Avoid

While many exercises, including those listed above, are helpful in healing spondylolisthesis, others are detrimental. Generally, you should avoid weightlifting, high-impact exercise, and exercises that require excessive bending and twisting. Examples of high-impact physical activities are running, football, and basketball. 

These activities place excess strain on the spine, which can lead to further damage in spondylolisthesis patients. Your physician can advise you on other activities to avoid with this spinal condition. 

Does Spondylolisthesis Ever Heal?

Mild spondylolisthesis cases can successfully heal over time with non-surgical therapies. However, patients with more severe forms of the condition may require surgery to make a complete recovery. 

Spinal specialists generally recommend that spondylolisthesis patients undergo six months to one year of conservative treatment. If this approach doesn’t produce any improvement, surgery may be considered. 

Can Spondylolisthesis Be Reversed Without Surgery?

As aforementioned, mild to moderate spondylolisthesis cases are often resolved with non-surgical treatments. These methods are generally preferable to surgery because they don’t involve the risks associated with spine surgery, including:

  • Blood clots
  • Infection
  • Dural tear (a tear in the sac of tissue that encloses the spinal cord and nerves)
  • Leaked CSF (cerebrospinal fluid)
  • Nerve injury

Studies have found that bracing and exercises that target lumbar extension, range of motion, and strengthening the abdominal and back muscles are the most effective non-surgical therapies for spondylolisthesis. Physical therapists can guide spondylolisthesis patients on the best exercises for their needs.

Other non-surgical treatment options include chiropractic care, acupuncture, massage therapy, electrical stimulation, pain medication, and steroid injections. Lifestyle modifications are also often helpful in speeding up patients’ spondylolisthesis recovery and may include:

  • Quitting smoking, which inhibits the body’s natural healing process and can accelerate spinal disc degeneration
  • Maintaining a healthy weight to prevent excess strain on the spine
  • Practicing good posture, especially while you’re working and exercising
  • Exercising regularly (while following your doctor’s instructions)
  • Eating a balanced, nutrient-dense diet and drinking plenty of water

What Is The Best Treatment For Spondylolisthesis?

The non-surgical therapies mentioned earlier in this article are widely considered the best treatments for spondylolisthesis. However, with cases of spondylolisthesis that don’t respond to these therapies, patients may need to consider surgical treatment

Laminectomy and/or spinal fusion are the predominant surgical methods used to treat spondylolisthesis. Here’s what you need to know about these procedures:

  • Laminectomy

Laminectomy generally involves removing part of the lamina, which is the section of bone covering the back of each vertebra. By removing a portion of the lamina, your spinal surgeon can alleviate nerve compression in the area caused by spondylolisthesis. However, it’s important to note that the procedure won’t resolve arthritis in cases of degenerative spondylolisthesis. 

  • Spinal fusion

Laminectomy and other forms of spinal decompression can lead to spinal instability, which is already present with spondylolisthesis. To offset this risk, surgeons often perform spinal fusion

During spinal fusion, the surgeon places bone graft material in between the afflicted vertebrae. The bone graft will stimulate the fusing of these bones over the next several months. 

The fusion process eradicates all motion at the fused spinal segment. This prevents instability, but also holds the patient back from certain movements and activities. The fusion process can also speed up the degeneration of the surrounding segments, which is known as adjacent segment disease or ASD. 

Fusion Isn’t The Only Option!

Thankfully, spinal fusion is no longer the sole treatment option for spondylolisthesis patients who require surgery. The TOPS System from Premia Spine is a non-fusion implant that can be used to treat lumbar spondylolisthesis and spinal stenosis. As a new, advanced treatment option, it offers an exciting alternative for spondylolisthesis patients facing spinal fusion surgery. 

The TOPS System is a mechanical implant device that replaces the spinal tissue that’s extracted during spinal decompression procedures, like laminectomy. It affords the patient a controlled range of motion so that, unlike with spinal fusion, they can partake in a variety of activities.

Patients with spondylolisthesis who haven’t responded to non-surgical therapies should speak to their doctors about every available treatment option. For many, innovative solutions like TOPS can greatly enhance their spondylolisthesis recovery.