Slipped Vertebrae Treatment Options
Slipped vertebrae are also called Spondylolisthesis. That is a severe spinal condition that frequently causes low back pain. It can happen when one of the vertebrae (bones in the spine) slips out of place and hits the vertebra below. Many times, you can use nonsurgical treatments to relieve the symptoms. However, some people may require spondylolisthesis surgery.
What Is It?
Spondylolisthesis is a spinal condition. When one of the vertebrae moves too much, it slips out of place. That often occurs at the base of your spine (lower back). Usually, the slipped vertebrae in the lower back put too much pressure on the nerves, so you can experience pain in the legs or low back.
Are Spondylolysis and Spondylolisthesis the Same?
Both conditions can cause low back pain, and they are related but not the same.
With spondylolysis, the spine defect is caused by a crack or stress fracture in the spinal bones. Young athletes often get it.
Spondylolisthesis happens when your vertebra slips out of place to rest on the bones below. Sometimes, spondylolysis can cause slipped vertebra if a stress fraction is a cause for the slippage. Alternatively, the vertebra could slip out because of disc degeneration. The discs between the facet joints (the back parts of the vertebrae linking it together) and the vertebrae could wear down.
Bone-in the facet joints could grow back and over-grow, which causes an unstable and uneven surface area. This makes your vertebrae less likely to stay where they should. Regardless of the cause, if a vertebra slips out of place, more pressure is put on the bone below.
Most spondylolisthesis cases don’t have any symptoms. If you feel any leg pain, it might be caused by pinched nerve roots in the spinal canal. The compression happens because the vertebrae slip out of position and narrows the space needed for the nerves.
What Types of Spondylolisthesis Are There?
Before you consider an appropriate spondylolisthesis treatment, you need to know what types are out there. They include:
- Degenerative spondylolisthesis – This is the most common type and is caused by aging. With time, the discs cushioning the vertebrae lose water and thin. They can then slip out of place more easily.
- Isthmic spondylolisthesis – This happens from spondylolysis because the fracture or crack weakens the bones.
- Congenital spondylolisthesis – This happens when the baby’s spine doesn’t form correctly before birth. That person has a higher risk for slippage later because of the misaligned vertebrae.
Those are the most common reasons for spondylolisthesis, but here are some less common ones:
- Post-surgical spondylolisthesis – This is a slippage resulting directly from spinal surgery.
- Pathological spondylolisthesis – That happens when a tumor or disease (osteoporosis) causes it.
- Traumatic spondylolisthesis – You get this type if an injury causes your vertebrae to slip.
How Common Is It?
It is quite common to have slipped lumbar vertebrae, and it affects about 4 to 6 percent of the population. Many people have spondylolisthesis for years and don’t know it because they have no symptoms.
Degenerative spondylolisthesis happens because of age with normal wear and tear on your spine. It’s most common in women over 50 than in men.
Typically, isthmic spondylolisthesis is caused by spondylolysis and comes in the form of back pain in teens.
Who’s Most at Risk for Slipped Vertebrae?
You could be more at risk to get spondylolisthesis because of:
- Age – As you get older, you can develop degenerative spinal conditions. That causes more wear and tear on your spine to weaken the vertebrae. Older adults tend to be at a higher risk of spondylolisthesis if they have degenerative spinal problems, which becomes more common after you turn 50.
- Genetics – Some people have isthmic spondylolisthesis and are born with thin sections of the vertebra (pars interarticularis). That thin bone piece connects with the facet joints and links the vertebrae above and below, forming a working unit so that you can move your spine. Ultimately, those thin vertebrae areas are likely to slip and fracture.
- Athletics – Young athletes (teens and kids) who participate in certain sports could develop spondylolisthesis. Typically, football and gymnastics are the top contenders. Vertebra slippage often happens when children have a growth spurt. It’s one of the most common causes of back pain in teenagers.
Slipped Vertebrae Symptoms
Slipped vertebrae lower back symptoms can be severe, but some people don’t experience any issues. You may notice:
- Buttock pain
- Low back pain
- Muscle stiffness and tightness
- Tight hamstrings
- Pain that is worse with activities
- Pain that spreads down the leg (nerve root pressure)
- Trouble walking or standing
- Weakness, numbness, and tingling in the feet
Typically, the cause of spondylolisthesis is an overextension of the spine. However, genetics can play a role, and age can be problematic, too.
Your doctor is likely to do a physical exam and might ask about your symptoms. It’s important to be honest and forthright here. Then, he or she is going to request an imaging scan to confirm.
A spinal X-ray is often done to help the doctor tell if your vertebrae are out of place. However, you may also need an MRI or CT scan so that the doctors can see the spine in better detail or to check the soft tissue for nerves and discs.
Slipped Vertebrae Treatment
Getting the right slipped vertebrae lower back treatment can be a challenge, and you may have to use trial and error to find the right one(s). Nonsurgical spondylolisthesis treatment options can include:
- Rest – You may have to stop doing sports and other activities so that the back feels better.
- Injections – Your doctor might recommend an injection of different steroid medicines right in the affected area.
- Medication – Over-the-counter NSAIDs (Nonsteroidal anti-inflammatory drugs) like naproxen (Aleve) or ibuprofen (Motrin) can help bring relief. If they don’t work, you may be prescribed something stronger.
- Bracing – A brace could stabilize the spine. This limits movement so that the cracks and fractures heal. However, braces can’t be used by adults.
- Physical therapy – Your physical therapist may give you some exercises for slipped vertebrae. They focus on strengthening the back and belly. You may need to perform these slipped vertebrae exercises each day to relieve the pain. However, it could take a couple of weeks to see results.
Is Surgery Needed?
If you’ve tried all the other spondylolisthesis treatment options and nothing has worked (or they quit working), you might need surgery. It might also be necessary if the pain is severe. Surgery can help:
- Restore function
- Stabilize the spine where the vertebrae have slipped
- Pain relief for the irritated nerves
Spondylolisthesis surgery requires spinal decompression. During this procedure, the surgeon removes discs and bone from your spine. That way, the nerves have more space, and the pain is relieved.
Generally, decompression therapy isn’t done alone. Fusion is often the next step. When that happens, the surgeon connects the two vertebrae together and fuses them. They heal and form into a single bone. This eliminates any movement from those two vertebrae. Most people have limited flexibility because of that.
There is another option, though. The TOPS implant can be used after decompression therapy. Instead of fusing the vertebrae together, a motion-preserving implant device is used. You can often walk around the next day and still have movement within the spine.
There are plenty of slipped vertebrae treatment options, and they work well for most people. It might be time to consider spondylolisthesis surgery if you find that exercises for slipped vertebrae don’t reduce your slipped vertebrae lower back symptoms. With decompression therapy and the TOPS implant, you could restore your quality of life.