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Spondylolisthesis

How I Cured My Spondylolisthesis Naturally?

May 1, 2024 by User_01 Sortino Marketing

Spondylolisthesis is a potentially debilitating spinal condition. It develops when one of the vertebrae of the spine slips out of its proper position and settles on the vertebra beneath it. The misaligned vertebra can cause persistent back pain and neurological symptoms.

If you’ve been diagnosed with spondylolisthesis, you may be concerned about the possibility of undergoing surgery. But, is it possible to cure spondylolisthesis naturally? We’ll explore this topic below.

Is Natural Treatment of Spondylolisthesis Possible?

To return the misaligned vertebra to its normal position in spondylolisthesis patients, surgery is necessary. Non-surgical treatments can’t alter the position of the vertebrae. However, natural treatments may alleviate the symptoms of spondylolisthesis in many cases.

Natural treatments of spondylolisthesis that may help resolve the disease symptoms include:

Physical therapy

Physical therapy is considered one of the most effective non-surgical treatments for spondylolisthesis. It works by strengthening the muscles that support the spine, promoting healthy lifestyle choices, and improving spine flexibility. Your physical therapist can also help improve your posture, which significantly improves spondylolisthesis symptoms.

Chiropractic care

Chiropractic care is a form of integrative medicine that centers around the neuromusculoskeletal system. Chiropractors can provide manual adjustments to improve the alignment of the spine and promote the body’s self-healing processes. This may help treat symptoms of nerve compression caused by spondylolisthesis.

Lifestyle changes

Certain lifestyle changes can help improve spondylolisthesis symptoms. For one, reaching and maintaining a healthy weight reduces the amount of impact on the spine with daily motions.

Weight loss strategies including a balanced diet and regular exercise routine can also help improve the overall health of your spine. Low-impact exercise, in particular, helps strengthen the back muscles that support the spine while promoting circulation and improving flexibility.

Can Spondylolisthesis Heal Itself?

As we mentioned in the previous section, surgery is required to return the misaligned vertebra to its prior position. The body can’t do this on its own.

However, especially in young, otherwise healthy individuals, resting and engaging in non-surgical therapies can resolve spondylolisthesis symptoms. Surgery is generally only required in severe spondylolisthesis cases that don’t improve despite several months of conservative treatment.

How Long Does Spondylolisthesis Take to Heal?

The amount of time that spondylolisthesis takes to heal largely depends on the patient’s age and the severity of the condition. For example, kids and teens with mild to moderate spondylolisthesis generally heal within three to six months (with rest, physical therapy, and bracing, if needed).

In adults with degenerative spondylolisthesis, the spine takes longer to heal. Patients will likely need to keep up with activity modifications, physical therapy, and other conventional treatments for several months to experience results. Additionally, patients with degenerative spondylolisthesis may be advised to permanently avoid activities that put the spine at risk.

What Should You Not Do With Spondylolisthesis?

Certain activities can make spondylolisthesis worse and should be avoided by patients with this diagnosis. These activities generally include high-impact sports, such as gymnastics, football, diving, and competitive swimming, as well as weightlifting.

In addition to physical activities that can strain the spine, spondylolisthesis patients should avoid having poor posture. With poor posture, the spine is out of its proper alignment, which increases the impact on the spinal structures and tissues.

Does Sitting Aggravate Spondylolisthesis?

While sitting isn’t a cause of spondylolisthesis, it may worsen the symptoms of this condition. Spondylolisthesis patients may experience pain flare-ups when sitting for prolonged periods.

You’re more likely to experience spinal pain if you’re sitting in a twisted, hunched, or slouched position. The best way to sit with spondylolisthesis is to keep your spine neutral, with the lower back entirely supported by the back of the chair.

If you have a sedentary occupation, consider investing in a desk chair with excellent lower back support. Try to keep your head in line with your spine as you’re working, not bent forward toward the computer screen.

Does Walking Help Spondylolisthesis?

Spondylolisthesis is commonly recommended for spondylolisthesis patients. As a low-impact form of exercise, walking is an excellent way for patients to retain muscle strength and joint mobility without straining the lumbar spine.

Spine specialists often recommend that spondylolisthesis patients start with short daily walks. Make sure to maintain a neutral, aligned spine as you walk. To prevent spondylolisthesis symptoms on your walk, start with five-to-10 minute walks, increasing the time gradually as recommended by your doctor or physical therapist.

The Importance of Timely Doctor Appointments in Spondylolisthesis Treatment

Spondylolisthesis can progress over time, making it crucial to receive prompt treatment. The longer you wait to receive spondylolisthesis treatment, the more likely you are to develop a severe form of the condition.

Timely doctor appointments for spondylolisthesis can also help you heal with conservative treatment, such as physical therapy, rest, and lifestyle modifications. Patients who don’t seek out timely care may eventually require surgery to resolve their symptoms.

Permanent Cure for Lumbar Spondylolisthesis

There’s no permanent cure for lumbar spondylolisthesis. However, spondylolisthesis treatment can provide long-term symptom relief.

Non-surgical treatments can’t cure lumbar spondylolisthesis, per se. Rather, conservative therapies help alleviate spondylolisthesis symptoms by promoting optimal spinal alignment, reducing inflammation, and supporting the body’s natural healing process.

As mentioned in a prior section, only surgery can return the displaced vertebra to its proper position. Still, it’s important to note that surgery isn’t guaranteed to be a permanent cure for lumbar spondylolisthesis. However, continuing innovations in the medical field are improving success rates and reducing the need for re-operation.

Is Surgery for Lumbar Spondylolisthesis Permanent?

While spondylolisthesis surgery is considered permanent, recurring pain and future spinal problems are possible. These problems can be caused by:

Hardware failure: The hardware used in spondylolisthesis surgery, like screws, rods, and implants, can fail over time. This failure may result from excessive impact on the hardware, or it may simply malfunction. This problem is more likely to occur in younger patients, as the hardware is subject to impact over a longer period than older patients.
Failed fusion: Also known as pseudoarthrosis, failed spinal fusion occurs when the vertebrae don’t properly fuse. This can trigger pain and poor range of motion. Various factors can increase your risk of a failed fusion, including moving too soon after fusion, smoking, and underlying medical conditions like osteoporosis and diabetes.
Adjacent segment degeneration: In spinal fusion patients, adjacent segment degeneration (ASD) can cause recurrent back pain. ASD develops when the vertebrae above and below the fused segment degenerate more rapidly than they should. This occurs because these segments undergo more impact to accommodate the fusion.

While the problems listed above mean that surgery isn’t a guaranteed cure for spondylolisthesis, it has positive outcomes for most patients (who are good candidates for the procedure).

Surgery Options for Severe Grades of Spondylolisthesis

Patients with severe spondylolisthesis generally require surgery to relieve their symptoms. The typical procedure used for spondylolisthesis is a laminectomy paired with spinal fusion or spinal fusion alone.

Laminectomy involves surgically removing some or all of the lamina, which is a section of bone that covers the back of the spinal canal. Removing a portion of the lamina can alleviate nerve compression triggered by spondylolisthesis.

Spinal fusion is done to resolve spinal instability in spondylolisthesis patients. Unfortunately, in permanently fusing the affected vertebrae, this procedure also eliminates all motion in the fused segment. This can create multiple issues, including lost mobility, adjacent segment degeneration, and muscle atrophy.

Spinal Fusion Alternatives For Spondylolisthesis

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Innovative spine devices have been developed to allow patients to avoid the downsides of fusion. One such device, the TOPS System, is designed for patients with degenerative spondylolisthesis and spinal stenosis in the lumbar spine. It stabilizes the spine while allowing for full motion at the operative level.

While many spondylolisthesis patients can heal naturally, others will require surgery to make a full recovery. In either case, make sure to schedule an appointment with a local spine specialist to receive prompt treatment.

Spondylolisthesis

How To Sit and Sleep With Spondylolisthesis?

April 27, 2024 by User_01 Sortino Marketing

If you have symptomatic spondylolisthesis, you likely know that the condition can make it difficult to sit and sleep comfortably. This spinal disorder occurs when one vertebra in the lumbar spine slips out of position and sits on the vertebra directly beneath it. When this occurs, the displaced vertebra may press on spinal nerves and/or the spinal cord, leading to pain and neurological symptoms.

With the few simple adjustments provided below, you can sit and sleep in comfort despite a spondylolisthesis diagnosis.

How To Sleep If You Have Spondylolisthesis?

To sleep comfortably with spondylolisthesis, you must focus on alleviating pressure on the lower back.

Sleeping on your stomach tends to force the spine into an arched position, which places extra stress on the lumbar spine. This is why lying on the stomach tends to be the worst sleeping position for spondylolisthesis patients.
Side-sleeping with bent knees involves less compression of the lower spine. However, this position can also lead to tight hip flexor and quadricep muscles. If sleeping on your side is the most natural position for you, try to keep only a slight bend in your knees to minimize muscle tension.
Sleeping on your back is widely considered to be the best sleeping position for spinal health. Unfortunately, it’s also the least natural sleeping position for many people, so it may take time to get used to. Placing a rolled-up towel or pillow beneath your knees can further reduce the arch in your lumbar spine while sleeping on your back.

Some patients with spondylolisthesis achieve the most pain relief while sleeping in a reclined position. Reclining keeps your legs at an angle to your torso, which can minimize the stress on your spine. You can try this sleeping position by using pillows to prop up your torso, and if it benefits you, you may want to consider an adjustable bed.

Does Sitting Cause Spondylolisthesis Pain?

Sitting doesn’t directly cause spondylolisthesis. However, in patients who have spondylolisthesis, sitting can trigger pain flare-ups. Specifically, sitting in a slouched, twisted, or bent position can lead to spondylolisthesis pain.

What Worsens Spondylolisthesis?

High-impact exercise, poor posture, excessively twisting the spine, and prolonged bed rest can worsen spondylolisthesis.

High-impact exercises like running, jumping, weightlifting, and contact sports can worsen spondylolisthesis. These activities place excessive impact on the spine, which can exacerbate back and nerve pain. They also create the risk of acute injuries, like fractures and contusions, which can lead to more pain.
Poor posture can worsen spondylolisthesis. When the spine isn’t in proper alignment, it strains the spinal structures and can aggravate nerve impingement from spondylolisthesis.
Excessive spinal twisting with spondylolisthesis can lead to worsened back pain and nerve impingement. Certain activities like gymnastics, diving, tennis, and golf require deep spinal twists. So, it’s best to avoid these if you’ve been diagnosed with spondylolisthesis.
Prolonged bed rest may seem like a good way to take stress off of the spine. However, this is a common mistake. While your doctor may recommend some rest after your spondylolisthesis diagnosis, don’t stay in bed for extended periods.
- Bed rest can cause muscle tension, which can worsen your symptoms. Over time, it may also cause muscle atrophy. If the muscles that support the spine weaken, it will increase the impact on your spine with day-to-day movements.

What About Asymptomatic Spondylolisthesis?

It’s also worth noting that some cases of spondylolisthesis are asymptomatic. This occurs if the vertebra slips out of place, but doesn’t irritate nearby spinal nerves. If you have asymptomatic spondylolisthesis, you can often safely perform any activity that doesn’t trigger pain or neurological symptoms.

However, if any activities start to cause discomfort, stop and talk to your doctor. They can provide personalized activity modification guidance according to your work and general lifestyle. They may recommend avoiding:

Lifting heavy objects
Deep stretching or twisting
Any extreme or sudden movements involving the spine

How To Sit Comfortably With Spondylolisthesis?

If you have spondylolisthesis, sitting with good posture in a chair with adequate lower back support is ideal for pain prevention. Good posture while sitting involves keeping your back straight with your shoulders back and relaxed. If you’re working on a computer, the screen should be positioned at eye level so that you don’t have to tilt your head up or down.

Placing a rolled-up towel or a lumbar roll pillow behind your lower back can help you sit comfortably in chairs without enough support. Additionally, make sure to keep your hips level and your legs uncrossed while you sit to keep your lumbar spine aligned.

How Long Does Spondylolisthesis Pain Last?

Spondylolisthesis may last for different periods depending on the patient. Many young individuals with spondylolisthesis recover within just three to six months after receiving proper treatment. In older individuals, pain may require several months of treatment to subside.

Patients who require surgery for spondylolisthesis may need six months to one year to fully recover after the procedure. This recovery period can vary depending on the procedure.

How is Surgery Used To Relieve Spondylolisthesis Pain?

Spinal decompression with spinal fusion is the most common surgical treatment approach for spondylolisthesis. Spinal decompression involves removing certain spinal structures to alleviate nerve compression.

Fusion involves permanently fusing the affected vertebrae to form a single bone using bone graft material. This process inhibits all motion between the vertebrae to prevent instability.

Unfortunately, spinal fusion involves a lengthy recovery period, can severely limit patients’ mobility, and creates the risk of adjacent segment disease, or ASD. For these reasons, more patients are considering innovative non-fusion implants, such as the TOPS System from Premia Spine.

Regain your mobility with Premia Spine! Contact us now

How To Stop Spondylolisthesis Pain?

Aside from spondylolisthesis treatment surgery, several conservative treatment methods can help most patients overcome spondylolisthesis pain. These methods include:

Healthy habits

Adopting healthy habits helps speed healing and alleviate pain for spondylolisthesis patients. These habits may include quitting smoking, engaging in a low-impact exercise regimen, eating a nutrient-dense diet, and avoiding activities that strain the spine.

Pain medications

Pain medications may be used to help patients with lumbar spondylolisthesis manage pain and inflammation during the recovery process. Your physician can advise you on whether to use over-the-counter or prescription medications.

Physical therapy

Physical therapy is an imperative part of the recovery process for most spondylolisthesis patients. It’s used to alleviate pain by strengthening the back and abdominal muscles, improving mobility, correcting poor posture, and reducing inflammation. Physical therapy is implemented in both non-surgical treatment plans and post-op recovery plans for spondylolisthesis patients.

Bracing

Patients of all ages with spondylolisthesis may benefit from wearing a brace to stabilize the spine while it heals.

Spondylolisthesis can be painful and uncomfortable. However, with the proper care, you can overcome spinal pain, stiffness, and other symptoms.

If you have spondylolisthesis, consider reading more about Premia Spine TOPS System – this is a proven alternative to the spinal fusion of the lumbar region of the spine.

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What Part of the Spine Is Spondylolisthesis?

March 20, 2024 by User_01 Sortino Marketing

With spondylolisthesis, one of the spinal bones (vertebra) slips out of its usual position and rests on the bone beneath it. But, what part of the spine is spondylolisthesis primarily located? Considering that an estimated 39 million people are diagnosed with this condition each year, this is a common question among patients today.

In this article, we’ll explore the areas of the spine affected by spondylolisthesis to help you better understand this condition and the path to improved spinal health.

Where Is Spondylolisthesis Located?

Spondylolisthesis is most commonly located at the L5-S1 spinal level.

L5-S1 links the lumbar spine to the sacral spine, which is the area of the spine between the lower back and tailbone. The lumbar and sacral regions of the spine are highly flexible and support the rest of the spine in various positions. This combination of mobility and day-to-day impact makes these parts of the spine particularly susceptible to degenerative conditions, including spondylolisthesis.

Spondylolisthesis affecting the L5-S1 level is also known as lumbosacral spondylolisthesis. It develops when the L5 vertebra slips over the S1 vertebra and can cause symptoms including:

Lower back pain
Pain that radiates to the buttocks and/or thighs
Weakness, numbness, or tingling in the buttock(s) and/or thigh(s)
Tight hamstring muscles
Difficulty standing and/or walking for prolonged periods
Reduced range of motion in the lower back

Many people with L5-S1 experience relief from lower back pain, numbness, weakness, and tingling when they sit or bend forward. These motions create more space in the spinal canal, which alleviates pressure on the spinal nerves compressed by the displaced vertebra.

Symptoms of Severe L5-S1 Spondylolisthesis

If nerve compression from L5-S1 becomes severe, or if the condition is left untreated, it can cause serious symptoms, including:

Severe chronic back pain
Loss of bowel or bladder control
Loss of sensation in the legs
Reduced motor function in the legs
Saddle anesthesia

The symptoms listed above indicate cauda equina syndrome, a serious possible complication of L5-S1 spondylolisthesis. The cauda equina is a collection of nerve roots usually positioned at the L1 to L5 spinal levels. It contains nerve roots that supply motor and sensory function to the bladder, legs, anus, and perineum.

Is Spondylolisthesis Always L5 S1?

Spondylolisthesis isn’t always L5 S1. It can affect any spinal level.

With that said most cases of spondylolisthesis impact the lower lumbar spine. Besides L5-S1, the L4-L5 spinal levels are very commonly affected by this spinal condition. L4-L5 is often associated with degenerative spondylolisthesis, while L5-S1 is the most prevalent site of isthmic spondylolisthesis.

Degenerative vs. Isthmic Spondylolisthesis

Degenerative and isthmic spondylolisthesis are distinct types of this spinal condition.

Degenerative spondylolisthesis results from age-related spinal changes and gradual wear and tear. It tends to occur in patients over age 50, and its prevalence rises with advanced age.
Isthmic spondylolisthesis results from a fracture or defect of the pars interarticularis (the bone that links the facet joints of the spine). This form of spondylolisthesis is more prevalent in teens and young adults. But, if it’s not recognized at a younger age, it can cause symptoms that worsen in adulthood.

Why is Spondylolisthesis Common at L4-L5?

L4 and L5 are the two lowest vertebrae of the lumbar spine. They must support all of the vertebrae above when you move, and this physical stress can lead to degeneration over time. Additionally, as mentioned above, the lumbar spine is highly flexible, making this spinal level particularly susceptible to wear and tear.

What Is Grade 1 Spondylolisthesis L4 L5?

Grade 1 spondylolisthesis L4-5 is the most minor form of spondylolisthesis. It’s classified as a 0% to 25% slippage of the affected vertebra by the Meyerding classification system.

As the least severe type of spondylolisthesis, grade 1 or “low-grade” spondylolisthesis of the L4-L5 levels may not cause any symptoms, at first. But, if the affected vertebra begins to impinge on nearby spinal nerves, it may trigger lower back pain and stiffness. Neurological symptoms like tingling, numbness, and weakness may follow as the condition progresses.

How Do You Treat Grade 1 Spondylolisthesis of L4 L5?

You can typically treat grade 1 spondylolisthesis of L4 L5 with conservative methods, like activity modifications, physical therapy, and pain medication.

While conservative methods can’t cure the slippage of the vertebra, they can help alleviate pain and inflammation. Non-surgical methods can also promote nerve healing. However, without surgery, it’s impossible to return the slipped vertebra to its proper position.

Grade 2 Spondylolisthesis L4 L5

Grade 2 spondylolisthesis is classified as a 25% to 50% slip of the vertebra. This is often still considered low-grade spondylolisthesis, and many people can manage their symptoms without surgery.

Grade 3 Spondylolisthesis L4 L5

Grade 3 spondylolisthesis involves a 50% to 75% slip of the vertebra. In this stage, the condition becomes more serious and may interfere with your daily activities. Prompt treatment is essential to curb the progression of grade 3 L4 L5 spondylolisthesis.

Grade 4 Spondylolisthesis L4 L5

Grade 4 spondylolisthesis is a 75% to 100% slippage. It’s a severe or “high-grade” form of spondylolisthesis that often requires surgery.

Grade 5 Spondylolisthesis L4 L5

Grade 5 spondylolisthesis occurs when there’s more than a 100% slip of the vertebra. This is also called spondyloptosis, and it’s fairly rare. Usually, grade 5 spondylolisthesis results from significant trauma to the spine and requires prompt surgical treatment to prevent neurological complications.

Determining Spondylolisthesis Grade and Location

To determine which part of the spine the slippage is located, your physician will likely order imaging tests, such as an MRI or CT scan. These scans allow your physician to view the vertebrae and confirm which spinal level is affected.

Your physician will use the results of imaging tests and the degree of your symptoms to determine the spondylolisthesis grade. With the Meyerding classification system, the physician draws a line through the posterior wall of the superior and inferior vertebrae to calculate the percentage of the distance between the lines.

Surgery for Spondylolisthesis of L4-L5

L4-L5 spondylolisthesis often requires surgery when conservative therapies don’t provide symptom improvement. Previously, patients had limited options for procedures to resolve this condition. Spinal fusion was considered the only way to restabilize the spine and correct the slippage caused by spondylolisthesis.

Spinal fusion is the process of permanently fusing two or more vertebrae for stabilization. It’s often performed after spinal decompression procedures, like laminectomy, which alleviates spinal nerve impingement. However, fusion comes with numerous downsides, including reduced mobility, extensive downtime, and the risk of failed fusion or adjacent segment degeneration.

Today, patients with lumbar spondylolisthesis have more options at their disposal. One option is the TOPS System, a non-fusion implant that restores a controlled range of motion in the spine. It provides lasting stability while allowing the spine to move in all directions, making it a game-changer for individuals with spondylolisthesis at L4-L5, L2-L3, or L3-L4.

Regain your mobility with Premia Spine! Contact us now

The TOPS System is approved by the FDA for lumbar degenerative spondylolisthesis and spinal stenosis. It’s also earned a superiority-to-fusion claim from the FDA, making it an exciting new option for individuals struggling with persistent spondylolisthesis symptoms.

Find a physician in your area today to learn more about TOPS for lumbar spondylolisthesis.

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Spondylolisthesis Surgery Overview

March 4, 2024 by User_01 Sortino Marketing

Spondylolisthesis is a spinal condition that can cause significant back pain and numbness, tingling, or weakness in the extremities. In most cases, people with this condition recover without having to go under the knife. But, when non-surgical therapies fail, spondylolisthesis surgery may be necessary.

In this article, we’ll provide a comprehensive overview of spondylolisthesis surgery and when to consider it for your spinal symptoms.

How Spondylolisthesis Surgery Is Made

Spondylolisthesis surgery is done by stabilizing the spine and resolving any compression on the spinal nerves. This is known as spinal decompression.

Stabilization in spondylolisthesis surgery may involve spinal fusion or the implantation of a non-fusion device.

Is Spondylolisthesis Surgery a Major Surgery?

Spondylolisthesis surgery is usually a major surgery, as it’s performed under general anesthesia and may involve cutting into the back muscles to access the spine.

However, with the latest medical advancements, minimally invasive techniques may be used in spondylolisthesis surgery. Unlike traditional spine surgery, minimally invasive spondylolisthesis surgery involves a small incision and doesn’t disrupt the back muscles or organs near the spine.

What Is the New Surgery for Spondylolisthesis?

The new surgery for spondylolisthesis is non-fusion spinal decompression surgery.

The non-fusion approach to spondylolisthesis surgery involves stabilizing the spine without permanently fusing the affected vertebrae. Instead, a non-fusion implant (like the TOPS System) is inserted into the spine to create a controlled range of motion.

Regain your mobility with Premia Spine! Contact us now

The TOPS System is a mechanical implant device indicated for degenerative spondylolisthesis and spinal stenosis at the L2 to L5 spinal levels. In June 2023, the FDA approved TOPS for these conditions and granted the device a superiority-to-fusion claim.

What Is the Success Rate for Spondylolisthesis Surgery?

The success rate of spondylolisthesis surgery ranges from 70% to 88%, depending on the procedure and the severity of the condition.

The TOPS System for spondylolisthesis had an overall success rate of 76.7% in a clinical study of 115 people who reached two years of follow-up.

What Affects the Success Rate of Spondylolisthesis Surgery?

Many factors may be considered in the success rate of spondylolisthesis surgery, including:

Decreased pain: A key determinant in the success rate of a spondylolisthesis procedure is pain relief. To be considered successful, the surgery must provide a lasting, significant improvement in pain and other spondylolisthesis symptoms, like tingling, numbness, and weakness in the extremities.
Increased function: Similarly, a successful spondylolisthesis surgery must improve the patient’s ability to complete daily tasks and participate in various activities.
Rate of complications: A low rate of complications indicates that surgery is successful. Some of the possible complications of spondylolisthesis procedures include nerve injury, chronic pain, infection, hardware failure, fusion failure, and blood clots.
Patient satisfaction: Patient satisfaction is an important factor to consider when contemplating surgery for spondylolisthesis.

What’s the Rate of Complications in Spondylolisthesis Surgery?

The rate of complications in lumbar spinal fusion surgery can vary from 29% to 62%. The TOPS System for spondylolisthesis had a complication rate of 7.2% in a prospective study.

Is Surgery Worth It for Spondylolisthesis?

Surgery may be worth it for spondylolisthesis if your symptoms are inhibiting your daily activities and compromising your quality of life.

Additionally, surgery is often worthwhile for spondylolisthesis in patients who haven’t responded to non-surgical therapies, like:

Physical therapy
Chiropractic care
Pain medications
Bracing
Corticosteroid injections

Signs That Spondylolisthesis Surgery May Be Worth it For You

Spondylolisthesis may be worth it for you if:

You’re still experiencing moderate to severe spondylolisthesis symptoms after six to 12 months of conservative treatment.
You have to significantly modify your daily activities to accommodate spondylolisthesis symptoms.
You’re unable to work or complete essential daily tasks because of spondylolisthesis.
Spondylolisthesis has severely compromised your quality of life.

Is Spondylolisthesis Surgery Safe?

Spondylolisthesis surgery with clinically proven procedures is considered safe for qualifying patients.

To ensure the safety of spondylolisthesis surgery, it’s essential to choose a qualified spinal surgeon. Look for the following qualifications:

A license to practice in your state
A college degree including premedical education, medical school, and residency in orthopedic surgery or neurosurgery
A board certification in orthopedic or neurological surgery
A fellowship in spinal surgery

Additionally, make sure that:

The surgeon’s practice is largely focused on spinal surgery
The surgeon has earned many positive online reviews
The surgeon can provide testimonials from patients who have undergone the same procedure
The surgeon can clearly outline the procedure, required downtime, risks, and possible complications of the surgery
The surgeon provides realistic expectations for the results of the procedure, rather than claiming to be able to “cure” you

What Is the Age Limit for Spinal Surgery?

There’s no set age limit for spinal surgery. However, your surgeon will consider your age before recommending surgery for spondylolisthesis.

Younger patients with spinal conditions have a higher risk of reoperation than older patients. This is because they may outlive the hardware’s lifespan, and hardware failure can lead to complications. Thankfully, younger patients rarely require spondylolisthesis surgery and usually recover with non-surgical therapies.

On the other hand, elderly patients often face a higher risk of surgical complications due to underlying conditions. Seniors must be in good general health to safely undergo major spinal surgery.

The TOPS System is indicated for patients between the ages of 35 and 80 with degenerative spondylolisthesis.

What Happens if You Don’t Fix Spondylolisthesis?

If you don’t fix spondylolisthesis, you may experience chronic back pain and complications from permanent spinal damage.

Possible complications of untreated spondylolisthesis include:

Spinal Stenosis

Without prompt treatment, spondylolisthesis can cause spinal stenosis. Spinal stenosis is another spinal condition involving the narrowing of the spinal canal. It often causes neurological symptoms like numbness, tingling, and weakness.

Paralysis

In severe cases, untreated spondylolisthesis can lead to permanent nerve damage, which can lead to cauda equina syndrome and paralysis. Cauda equina syndrome develops when the group of nerves and nerve roots at the bottom of the spinal cord becomes compressed. These nerves supply sensory function to the legs, bladder, anus, and perineum.

If you experience signs of cauda equina syndrome, seek emergency medical care to prevent permanent paralysis. Warning signs of this condition include:

Urinary retention (not feeling the urge to urinate, despite having a full bladder)
Numbness of the buttocks, upper inner thighs, genitals, and perineum
Weakness or paralysis of the lower extremities
Bladder or bowel incontinence
Sexual dysfunction

Spinal Deformities

Left untreated, spondylolisthesis can cause spinal deformities, like a round back or swayback, over time. These deformities can accelerate spinal degeneration and increase your risk of developing other spinal conditions.

What Is the Best Choice for Spondylolisthesis Surgery?

The best choice for spondylolisthesis is generally minimally invasive spinal decompression with non-fusion stabilization. This can be achieved with the TOPS System, as mentioned above.

Rather than permanently fusing the vertebrae, the TOPS System restores a controlled range of motion in the spine. It allows the spine to move in all directions, unlike spinal fusion but resolves the instability associated with spondylolisthesis. Additionally, the TOPS System replaces the soft and bony tissues removed during the decompression procedure, providing relief from pain and neurological symptoms.

The TOPS System is FDA-approved for degenerative spondylolisthesis and spinal stenosis between the L2 to L5 segments of the lumbar spine. To learn if you’re a candidate for this modern form of spondylolisthesis surgery, find a licensed surgeon in your area today.

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Spondylolisthesis in Children and Adolescents

February 6, 2024 by User_01 Sortino Marketing

Spondylolisthesis is a condition involving spinal instability. It develops when a vertebra slips out of its normal position and rests on the vertebra below. This can trigger back pain and nerve compression.

Though common in older adults, spondylolisthesis is a prevalent cause of lower back pain in children and adolescents. In this article, we’ll discuss how spondylolisthesis affects younger patients and what can be done to treat it.

How Does Spondylolisthesis Occur in Adolescents?

Spondylolisthesis most often occurs in adolescents as a result of spondylolysis, which is a stress fracture in the pars interarticularis. This is known as isthmic spondylolisthesis.

The pars interarticularis is a piece of bone that links the spine’s upper and lower facet joints. When it fractures, it destabilizes the affected vertebrae, potentially causing spondylolisthesis.

Symptoms of Spondylolisthesis in Children and Adolescents

The most common symptoms of spondylolisthesis in children and adolescents include:

Lower back pain
Thigh and buttock pain
Muscle stiffness in the lower back
Tenderness in the lower back
Tight muscles (particularly the hamstrings)

Lower back pain from spondylolisthesis may feel like a back muscle strain. However, it persists longer than a muscle strain and will likely worsen without proper care.

In some cases, the vertebra moves far enough out of its proper position to impinge on the spinal nerves. This can trigger worsened pain and neurological symptoms, such as:

Pain that radiates from the lower back down the legs
Weakness in the legs or difficulty walking
Numbness and tingling in the lower extremities

Rarely, spondylolisthesis can cause urinary incontinence and permanent nerve damage if it’s left untreated.

What Is the Most Common Type of Spondylolisthesis in Children?

The most common types of spondylolisthesis in children are isthmic and congenital.

Congenital spondylolisthesis may also be called dysplastic spondylolisthesis. It results from a genetic spinal defect that’s present at birth. The defect affects the facet joint(s) of the spine, which compromises the stability of the entire vertebral column.

What Is the Most Common Age for Spondylolisthesis?

The most common age for isthmic spondylolisthesis is around age 6, or in adolescents.

The most common age for degenerative spondylolisthesis is over 50. Degenerative spondylolisthesis develops from age-related wear and tear on the spine. Age causes the intervertebral discs and other vertebral structures to thin and weaken. This increases the likelihood that a vertebra will slip out of place.

What Are the Risk Factors for Spondylolisthesis in Children?

Risk factors for spondylolisthesis in children include:

Repeatedly overextending the spine, typically in sports

Young athletes are more likely to experience spondylolisthesis than those who don’t partake in sports. Many sports place significant impact on the spine, including the pars interarticularis, and may lead to spinal stress fractures.

Genetic spinal defects

Some individuals are born with a defect in the pars interarticularis that can cause spondylolisthesis. Not all genetic spinal defects of the pars interarticularis trigger spondylolisthesis symptoms.

Obesity

Children and adults who are overweight or obese have a higher risk of developing spondylolisthesis. Excess weight increases the impact on the spine with daily movements, which may heighten the risk of a stress fracture in the pars interarticularis.

Which Sports Cause Spondylolisthesis?

The following sports are the most likely to cause spondylolisthesis in children and teens:

Soccer
Football
Diving
Gymnastics
Weightlifting
Tennis
Baseball

These sports are thought to increase the risk of spondylolisthesis because they involve repeatedly twisting and extending the spine. These movements impart a significant impact on the spinal tissues, including the pars interarticularis.

Is Spondylolisthesis Common in Children?

Spondylolisthesis is a common cause of lower back pain in children.

In one study, the incidence of spondylolysis (a pars interarticularis stress fracture) in children under age 11 was 2.5%. The incidence of spondylolysis by age 6 had been reported at 4.4%.

How Is Spondylolisthesis Diagnosed in Children and Adolescents?

Spondylolisthesis is diagnosed in children and adolescents with imaging tests, such as X-rays, CT scans, and lumbar MRI scans.

X-rays use electromagnetic waves to create images of the body, which may show that a vertebra has slipped out of position.
CT scans (computed tomography scans) use both X-rays and computer technology to create images of the inside of the body. CT images display details of bone, muscle, organ, fat, and blood vessel tissue.
MRI scans (magnetic resonance imaging) use radio waves and a magnetic field to show the inside of the body in detail, like CT scans. However, MRIs provide a more detailed image of soft tissue than CT scans.

How Is Spondylolisthesis Treated in Children and Teens?

Spondylolisthesis is typically treated in children and teens with conservative therapies. Surgery is rarely required to resolve symptoms of this spinal condition, especially in young patients.

Most young athletes who develop spondylolisthesis from a pars interarticularis fracture make a complete recovery with a prompt diagnosis and conservative treatment. They can usually make a full return to sports participation.

The most common treatments for spondylolisthesis in children and adolescents include:

Activity Modifications

The first step in treating spondylolisthesis in kids and teens is to limit activities that worsen symptoms. Young athletes with spondylolisthesis will likely need to take a break from sports until their pain improves. However, to retain strength and stamina, patients may be able to safely engage in low-impact exercise, like swimming.

Make sure to follow all of your physician’s recommendations for exercising with spondylolisthesis.

Bracing

Bracing the back can provide spinal stability during your spondylolisthesis recovery. A brace can help the pars interarticularis heal properly by supporting the spine.

A brace for spondylolisthesis, sometimes referred to as a lumbar brace or corset, compresses the abdomen to reduce impact on the spinal column. This temporarily limits your range of motion, which prevents strain on the spine. The brace may also provide pain relief.

As a drug-free, non-surgical treatment, bracing is one of the most widely recommended therapies for spondylolisthesis in children and adolescents.

Physical Therapy

Physical therapy is an important stage of treatment for kids and teens with spondylolisthesis. It involves stretches and strengthening exercises to alleviate impact on the spine. For spondylolisthesis, the physical therapist will likely focus on strengthening the back and abdominal muscles, which provide support for the spinal column.

Additionally, many patients with spondylolisthesis have tight hamstrings, which can cause worsened pain and diminished function. Physical therapists can provide stretches and other methods to loosen the hamstring muscles safely.

Pain Medications

Especially in the early stages of recovery, your physician may recommend pain medications, like NSAIDs, to manage spondylolisthesis symptoms. NSAIDs (nonsteroidal anti-inflammatory drugs) can lessen pain and swelling in the spine.

When is Surgery Required for Spondylolisthesis in Kids and Teens?

Surgery may be required for spondylolisthesis in kids and teens in severe cases that pose a risk of permanent nerve damage or disability.

In these cases, the vertebra has usually slipped far out of its normal alignment and continues to worsen despite conservative therapies. Spondylolisthesis surgery involves alleviating pressure on the spinal nerves (known as decompression) and stabilizing the spine, either with spinal fusion or a non-fusion implant.

If your child is exhibiting symptoms of spondylolisthesis, schedule an appointment with a physician near you for an evaluation.

Spondylolisthesis

Grade 1 Spondylolisthesis: Causes, Treatments, Recovery Forecasts

January 1, 2024 by User_01 Sortino Marketing

Spondylolisthesis is a prevalent spinal condition that may affect adults and teenagers alike. It develops when one of the vertebrae of the spine slips out of its regular position and lands on the vertebra below. The spinal misalignment caused by spondylolisthesis can lead to chronic back pain and nerve symptoms.

Physicians classify spondylolisthesis using a grading system based on the severity of the condition. Grade 1 spondylolisthesis is the least severe form of the disease, but can still cause significant discomfort.

This article will explore the topic of grade 1 spondylolisthesis, including the causes, treatments, and recovery forecasts for this condition.

Table of Content

What Does Grade 1 Spondylolisthesis Mean?

Grade 1 spondylolisthesis means that the affected vertebra has slipped between 1% and 25%. Also known as low-grade spondylolisthesis, grade 1 spondylolisthesis is found in virtually all patients with degenerative spondylolisthesis. Over time, without the appropriate treatment plan, grade 1 degenerative spondylolisthesis is likely to progress into a more severe form of the condition.

What Causes Grade 1 Spondylolisthesis?

Grade 1 spondylolisthesis is generally caused either by overextending the spine or by age-related spinal wear and tear. The former of these causes is common in young athletes who develop grade 1 spondylolisthesis; the latter occurs in cases of degenerative spondylolisthesis.

Overextending The Spine

Certain sports involve repeatedly extending the spine and involve a high risk of spinal injury. Young athletes who participate in these sports are more likely to develop grade 1 spondylolisthesis than others. Sports that may lead to overextending the spine include gymnastics, volleyball, diving, and football.

It’s also worth noting that some individuals are more likely to develop spondylolisthesis than others due to genetic factors. Specifically, some people naturally have thinner bone tissue in the vertebrae, leading to a higher risk of spinal injury.

Age-Related Spinal Wear and Tear

Throughout a lifetime, the spine is subject to wear and tear with daily activities. High-impact activities, like running and contact sports, as well as having poor posture, can worsen this degeneration. But, aspects of the natural aging process also contribute to age-related spinal wear and tear.

The spine inevitably changes with age. For one, the intervertebral discs that absorb impact to protect the spine become thinner and drier. Additionally, bone mass reduces with age, leading to thinner spinal structures that are more susceptible to injury.

All of these factors can contribute to the development of degenerative grade 1 spondylolisthesis, which typically affects patients over the age of 60.

Is Grade 1 Spondylolisthesis Serious?

Grade 1 spondylolisthesis is considered the least serious form of this spinal condition. Additionally, grade 1 and grade 2 are the most frequently diagnosed forms of spondylolisthesis.

While any spinal condition should be taken seriously to prevent ongoing pain and further injury, grade 1 spondylolisthesis is usually resolved fairly easily. However, if the condition isn’t identified early on, or if the patient doesn’t follow an effective treatment plan, spondylolisthesis can progress.

What Exercise Can You Do With Slight Grade 1 Spondylolisthesis?

With slight grade 1 spondylolisthesis, you can participate in many different forms of exercise, so long as they don’t excessively strain the spine. In fact, regular exercise is an important component of most spondylolisthesis treatment plans. This is because it promotes spinal mobility and muscle strength.

Some of the best forms of exercise for grade 1 spondylolisthesis include:

Walking
Swimming and water aerobics
Using an elliptical machine
Certain strengthening exercises, such as side planks and pelvic tilts
Gentle stretching
Non-intense cycling

Certain forms of exercise can lead to spondylolisthesis progression and worsened symptoms. These include:

Weightlifting
Some sports, including wrestling, gymnastics, football, and other contact sports
Yoga poses that involve back extension
Diving
Back extensions
Sit-ups and crunches
Any activity that involves significantly twisting or rotating the spine

Ultimately, you should talk to your doctor about which forms of exercises to participate in with grade 1 spondylolisthesis. As your back heals, your doctor may give you the go-ahead to partake in a wider range of physical activities.

Can I Run With Grade 1 Spondylolisthesis?

If you have grade 1 spondylolisthesis and are experiencing symptoms, it’s best to avoid running until your doctor clears you to do so. Running is a high-impact activity that can place extra stress on the spine. This may lead to worsened back pain and neurological symptoms.

What is The Treatment For Grade 1 Spondylolisthesis?

The treatment for grade 1 spondylolisthesis typically includes rest, activity modifications, physical therapy, and anti-inflammatory medications. If required, the patient may also undergo steroid injections or spinal bracing, which helps prevent spinal instability.

Does Grade 1 Spondylolisthesis Need Surgery?

Grade 1 spondylolisthesis generally doesn’t require surgery. This is because it’s the mildest form of the condition, so its symptoms can typically be alleviated with non-invasive methods. However, spine specialists may recommend surgery for grade 1 spondylolisthesis if:

Non-surgical treatment methods fail to provide relief after an extended period
Surgery is required to prevent the progression of the condition.
The altered alignment of the spine severely impacts the patient’s function and posture.

Unfortunately, grade 1 spondylolisthesis can’t be cured without surgery. Once the vertebra has slipped out of its normal position, surgery is the only way to restore the alignment of the spine. So, while non-surgical therapies can help with spondylolisthesis, patients may opt for surgery to correct the position of the misaligned vertebra.

Surgery For Grade 1 Spondylolisthesis

Traditionally, patients who require surgery for spondylolisthesis have undergone spinal fusion. This is rare for cases of grade 1 spondylolisthesis, but not impossible.

During spinal fusion, the surgeon places an implant containing bone graft material between the affected vertebrae. This bone graft material stimulates bone development in the months following the procedure. Eventually, this leads to the formation of a single, stabilized bone.

Unfortunately, in fusing the vertebrae affected by spondylolisthesis, spinal fusion eliminates the segment’s range of motion. To avoid this, along with various complications associated with fusion, patients can consider the TOPS System.

The TOPS System is a mechanical device that can be implanted into the spine at the affected segment to restore a controlled range of motion. It can be implanted with a minimally-invasive procedure and facilitates extension, flexion, axial rotation, and lateral bending.

The FDA has approved the TOPS System for people between 35 and 80 years old with degenerative spondylolisthesis (at one level between L3 to L5) and lumbar spinal stenosis. The FDA also labeled the TOPS System as superior to spinal fusion for lumbar spondylolisthesis with spinal stenosis.

Dr. Meyer, a neurosurgeon at the Atlantic Neuroscience Institute, was selected to participate in an FDA study of the TOPS System as a treatment for degenerative grade 1 spondylolisthesis and spinal stenosis. Dr. Meyer notes that the study presents patients with an opportunity to reap the benefits of this innovative device, including a restored range of motion, while correcting their spinal condition.

What is The Recovery Forecast For Grade 1 Spondylolisthesis?

The recovery forecast for most patients with grade 1 spondylolisthesis is a complete recovery within three to six months. However, this forecast can differ depending on the patient and the chosen treatment route.

Non-Surgical Treatment Route:

Cases of grade 1 spondylolisthesis that are successfully treated without surgery typically heal within three to six months, as mentioned above. Young patients may heal faster, while older patients may need more time to recover.

A spine specialist can evaluate your case of spondylolisthesis and provide a personalized recovery forecast based on your age, medical history, exact treatment plan, and degree of slippage.

Surgical Treatment Route:

Most patients who undergo TOPS surgery for grade 1 spondylolisthesis return to their regular activities within around six weeks. Patients also regain a complete range of motion right after the procedure. With this in mind, patients are subject to far fewer restrictions when compared to traditional spinal surgery after TOPS surgery.

After spinal fusion, which is the conventional surgical treatment for spondylolisthesis, patients typically need a full year to recover. Additionally, patients are subject to significant restrictions for around six to eight months following the procedure.

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Note that all motion in the fused vertebral segment is lost after spinal fusion, which may permanently inhibit some patients’ activities.

If you’ve been diagnosed with grade 1 spondylolisthesis, schedule an appointment with a spine specialist in your area to learn about all of the available treatment routes.

Spondylolisthesis

Spondylolisthesis Exercises Guide

December 4, 2023 by User_01 Sortino Marketing

Spondylolisthesis is a spinal condition that causes a vertebra to slip out of its normal position. The resulting misalignment of the spine can trigger back pain and weakness, tingling, and numbness that spreads to the extremities.

Many people assume that exercise is out of the question with a condition like spondylolisthesis. But, while certain activities should be avoided, low-impact exercise can benefit spondylolisthesis patients by preserving mobility, boosting circulation, and increasing muscle strength.

Read on for a complete spondylolisthesis exercises guide, including the best (and worst) exercises to perform if you’ve received a spondylolisthesis diagnosis.

Is It Safe to Exercise With Spondylolisthesis?

It’s safe to exercise with spondylolisthesis if:

Your physician has cleared you for physical activity.
The exercise doesn’t trigger pain or other symptoms.
The exercise is low-impact and doesn’t involve significant bending or twisting.

Which Type of Exercise Is Best for Spondylolisthesis?

The best type of exercise for spondylolisthesis is low-impact exercise.

Low-impact exercise, like walking and water aerobics, is the best exercise for spondylolisthesis because it doesn’t strain the spine. This form of exercise promotes mobility and improves circulation without placing stress on the spinal structures. This prevents flare-ups of pain and neurological symptoms, like numbness, tingling, and weakness.

Gentle stretching and strengthening exercises are also beneficial forms of exercise for spondylolisthesis. Stretching helps patients improve and maintain their range of motion while reducing muscle tension. Strengthening exercises for the back and core muscles improve support for the spine, preventing stress on the spinal structures with various activities.

Some of the best stretches and strengthening exercises for spondylolisthesis include:

Pelvic tilts: Pelvic tilts strengthen the deep core muscles and support healthy spinal motion. To perform this exercise, lie on your back with your feet flat on the ground. Draw your belly button toward the spine to engage the abdominal muscles, flattening your lower back against the floor. Hold this position for 15 seconds, relax, and repeat for several sets.
Curl-ups: This exercise targets the core muscles. To perform it, lie on the floor with your feet flat on the ground. Cross your arms over your chest or place your hands behind your neck, if it’s more comfortable. Gently engage your core muscles to lift your shoulder blades off the floor, keeping your head in alignment with your body. Stay in this position for a few seconds, return to the starting position, and repeat for up to 12 sets.
Double knee to chest: Lie on your back with your feet flat on the ground and your knees bent. Engage your stomach muscles, pressing your lower back into the floor. Draw both knees toward your chest, holding them with your hands. Hold this position for five seconds, return to the starting position, and repeat for 10 to 20 sets.

What Exercises Should You Avoid With Spondylolisthesis?

The exercises that you should avoid with spondylolisthesis include high-impact sports and exercises that involve excessively twisting or bending the spine.

High-Impact Sports and Spondylolisthesis

High-impact sports and activities are dangerous for patients with spondylolisthesis. This is because excessive impact on the spine can cause pain flare-ups, worsen existing nerve impingement, and cause further damage to the spine.

Examples of high-impact sports and exercises to avoid with spondylolisthesis include:

Soccer
Football
Rugby
Running
Weightlifting
Basketball
Hockey
Burpees
Jumping rope
Sledding
Skiing
Snowmobiling
Trampolining

High-impact exercise includes all contact sports, as well as any activities that involve both of the feet leaving the ground at the same time. These activities place significant stress on the joints throughout your body, including your spinal joints.

Excessive Spinal Twisting and Bending

Exercises and activities that involve excessively twisting and bending the spine aren’t advised with spondylolisthesis. Twisting and bending the spine can stress the tissues affected by spondylolisthesis, leading to increased pain and neurological symptoms.

Activities that require the spine to significantly twist and bend include:

Gymnastics
Certain yoga and Pilates poses (i.e. cobra)
Tennis
Pickleball
Diving
Golfing

Can Physio Fix Spondylolisthesis?

Physio can fix spondylolisthesis in some cases.

Also known as physical therapy or PT, physio is often the first treatment that doctors recommend for spondylolisthesis. It involves:

Strengthening the abdominal and back muscles to more effectively support the spine
Correcting inefficient or harmful movement patterns
Improving your posture and spinal alignment
Alleviating muscle tension to promote pain relief

Physical therapists recommend exercises to perform both during your PT appointments and at home. Over time, these exercises can reduce the strain on your spine and improve circulation to the injured tissue.

Along with targeted exercises, your PT may provide passive treatments. These treatments help lessen inflammation, pain, and tension:

Heat and/or cold therapy
Transcutaneous electrical nerve stimulation (TENS), uses electrical currents to stimulate the muscles, boost endorphin production, and encourage natural pain relief
Ultrasound therapy, which boosts blood flow to the spine for relief from tension, spasms, and stiffness
Deep tissue massage, which involves imparting pressure on the affected soft tissues in the spine to release tension

Is Massage Good for Spondylolisthesis?

Massage is good for spondylolisthesis because it boosts circulation and reduces muscle tension.

Tight, stiff muscles in the back and hamstrings are a common problem among people with spondylolisthesis. This muscle tension can even lead to painful spasms, which may hold you back from your regular activities. Tight muscles are a sign that your body is compensating for the misaligned vertebrae, but can exacerbate spondylolisthesis symptoms.

Massage therapy can improve or alleviate tight muscles from spondylolisthesis for relief from back pain and muscle spasms. Massage therapists manually manipulate the soft tissues to release points of tension and increase blood flow to the affected area. Healthy circulation to the spine is crucial for spondylolisthesis, as it ensures that the injured tissue receives oxygen and healing nutrients.

Massage also reduces inflammation by improving inflammatory signaling, reduces the body’s production of cortisol (the primary stress hormone), and boosts endorphin production. Endorphins are a group of hormones with natural pain-relieving and mood-boosting benefits.

It’s crucial to see a trained, licensed massage therapist for spondylolisthesis. The spine is a delicate area, and an inexperienced massage therapist may put you at risk of further injury.

When is Surgery Necessary for Spondylolisthesis?

Surgery may be necessary for spondylolisthesis if conservative treatments fail after several months or the patient’s mobility is severely affected.

In most cases, surgery is the last recommended course of treatment for spondylolisthesis. This is because surgery involves incisions, anesthesia, and significant downtime. Though rare, serious complications from spine surgery like paralysis and deep vein thrombosis are possible.

However, when spondylolisthesis symptoms persist despite months or years of non-surgical treatment, surgery may be the only remaining option to restore the patient’s quality of life. The most common surgical approach for spondylolisthesis is spinal fusion, which permanently fuses the affected vertebrae to restore stability.

Modern, non-fusion solutions like the TOPS spinal implant can effectively treat spondylolisthesis while preserving the spine’s range of motion. With a superiority-to-fusion claim from the FDA, the TOPS System has emerged as a superior treatment option for degenerative spondylolisthesis of the lumbar spine.

For personalized spondylolisthesis exercise recommendations and a comprehensive treatment plan, seek care from a spine specialist in your area.

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Spondylolisthesis in Athletes: Treatment and Return to Sports

October 18, 2023 by User_01 Sortino Marketing

Spondylolisthesis is a prevalent spinal condition among athletes. While many older adults experience spondylolisthesis due to spinal degeneration, certain sports place excessive strain on the spine that can lead to spondylolisthesis, even in children, teens, and young adults.

Thankfully, modern spinal treatments have created a clear path to relief from spondylolisthesis, and many athletes can successfully return to their sport of choice. Continue reading for more information about spondylolisthesis in athletes and how it’s treated.

What Causes Spondylolisthesis in Athletes?

Spondylolisthesis in athletes is caused by repeated stress on the lumbar spine, often in movements that require spinal hyperextension.

Repetitive strain on the spine can cause spondylolisthesis by weakening the vertebrae and stretching the spinal ligaments. This compromises the spine’s stability, causing a vertebra to slip out of position. Spondylolisthesis in athletes most often affects the lumbar spine, because it’s highly flexible and weight-bearing, often taking the brunt of the force from physical activity.

Sports and physical activities that require the spine to be in hyperextension have higher incidences of spondylolisthesis. This is because when the spine is in hyperextension, it’s not as effectively supported by the abdominal and back muscles. This leaves the vertebrae to bear a significant amount of impact, creating the risk of fractures, stretched ligaments, and general instability.

Genetic Factors and Spondylolisthesis

Some athletes are at an increased risk of developing spondylolisthesis due to genetic factors. For example, genetics can cause a thin pars area or weak hypoplastic facet joints. Both of these characteristics increase the risk of spinal instability and a displaced vertebra.

Additionally, some children are born with spondylolisthesis, which can worsen throughout childhood, especially if they participate in sports.

What Sports Should Be Avoided With Spondylolisthesis?

The sports that should be avoided with spondylolisthesis include:

Gymnastics: Gymnastics requires the spine to be in extreme hyperextension, placing great impact on the lumbar vertebrae.
Weightlifting: Weightlifting can place excessive strain on the lumbar spine, especially if the weightlifter doesn’t use proper technique and posture.
Skiing: Skiing (particularly downhill skiing) puts a high amount of impact on the vertebrae, making it one of the sports with the highest incidence of spondylolisthesis.
Diving: Diving repeatedly forces the spine into hyperextension, leading to a high risk of spondylolisthesis.
Rowing: Rowing involves a repetitive pulling motion with resistance in a seated position, which places significant strain on the lumbar spine over time.
Wrestling: Wrestling can force the spine into hyperextension and require the lumbar spine to bear significant weight, creating a heightened risk of spondylolisthesis.
Cricket: Cricket involves hyperextending the spine through repetitive twisting motions.
Baseball: Similar to cricket, baseball requires the spine to repeatedly twist excessively, creating the risk of lumbar spondylolisthesis.
Soccer: Soccer involves repeated lumbar hyperextension and rotation, making it one of the sports with a high incidence of spondylolisthesis.

What Sports Can You Do With Spondylolisthesis?

The sports that you can do with spondylolisthesis include:

Swimming: Swimming and water aerobics provide gentle resistance to encourage muscle strength without placing an impact on the spine. This makes it one of the most commonly recommended physical activities for athletes with spondylolisthesis.
Cycling: Cycling is a low-impact activity that keeps the spine leaning slightly forward, which is comfortable for some people with spondylolisthesis.
Zumba: Zumba is a dance workout that builds stamina and physical fitness without straining the spine. It can help people with spondylolisthesis remain active without flaring up their symptoms.
Pilates: Pilates is a form of low-intensity exercise that can provide therapeutic benefits for spondylolisthesis patients. It gently builds core, back, and leg strength without forcing the spine into hyperextension. Pilates also supports improved posture and spinal align
Walking and hiking: Walking and hiking are low impact and don’t involve extreme spinal positions. They can help people with spondylolisthesis remain active without causing symptom flare-ups.

In general, low-impact activities that don’t require spinal hyperextension or excessive spinal rotation are safe for people with spondylolisthesis. Nonetheless, talk to your doctor before starting any new type of exercise if you’ve been diagnosed with spondylolisthesis.

How Fast Is It Possible to Return to Sports After Spondylolisthesis Surgery?

It’s possible to return to sports after spondylolisthesis surgery as fast as three to six months after surgery.

Factors that may impact the speed of your return to sports after spondylolisthesis surgery include:

Age: Older individuals usually require more time to recover after surgery.
Underlying medical conditions: Patients with underlying medical conditions may have added restrictions during the surgery recovery process, making their return to sports slower.
Adherence to the surgeon’s aftercare instructions: Following all of your surgeon’s post-operative instructions is essential to making a quick return to sports. For the fastest possible recovery, adhere to all of the instructions, such as attending follow-up appointments and avoiding certain activities.
Physical therapy: Seeing a physical therapist consistently after spondylolisthesis surgery can help you make a faster return to sports. A physical therapist can provide exercises for improved muscle strength, stretches to alleviate tension and alternative therapies to alleviate inflammation (such as heat/cold therapy).
Type of spondylolisthesis surgery: Patients who undergo minimally-invasive spondylolisthesis surgery without fusion can often return to sports much faster than those who undergo conventional spinal fusion.

Spondylolisthesis Surgery for Athletes

Surgery is a spondylolisthesis treatment option for athletes in severe cases. It involves restoring spinal stability and alleviating any spinal nerve impingement.

Traditionally, surgery for spondylolisthesis involves decompression with spinal fusion. Spinal decompression procedures resolve nerve compression by removing any tissue that’s impinging on a spinal nerve. Types of spinal decompression include:

Laminectomy, during which some or all of the lamina is removed. The lamina is a piece of bone that covers the back of the spinal canal.
Discectomy, during which damaged spinal disc tissue is removed. A spinal disc is located in between each vertebra of the spine, providing shock absorption to prevent damage.
Foraminotomy, during which the foramen are enlarged, creates more space for the nerve roots that extend from the spinal canal.

Spinal fusion restores stability in the spine to resolve spondylolisthesis symptoms. It involves placing bone graft material in between the affected vertebrae. The graft stimulates bone formation, causing the vertebrae to fuse, eventually becoming a single spinal segment.

Fusion can effectively treat spondylolisthesis in athletes by stabilizing the affected vertebrae. However, it also eliminates all motion at the fused spinal segment. Especially for athletes who rely on spinal mobility to successfully play their sport, this procedure can be detrimental to their athletic careers.

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Additionally, spinal fusion can lead to degeneration of the adjacent vertebrae. This risk is heightened in athletes who place a significant impact on their spines.

Non-Fusion Implants for Athletes with Lumbar Spondylolisthesis

Thankfully, athletes can now opt for non-fusion spinal implants like the TOPS System to treat spondylolisthesis without fusion. The TOPS System is a mechanical device that restores a controlled range of motion in the spine. It alleviates lumbar spondylolisthesis symptoms while allowing the spine to move in all directions. Additionally, TOPS facilitates a far faster recovery process than that of spinal fusion.

To learn more about the TOPS system for spondylolisthesis in athletes, schedule an appointment with a qualified spine specialist near you.

Spondylolisthesis

Spondylolisthesis Symptoms

May 18, 2023 by User_01 Sortino Marketing

As the body’s most complex structure, the spine is particularly vulnerable to injury and degeneration. One possible spinal condition is spondylolisthesis, which affects the bones of the spine (called vertebrae).

With spondylolisthesis, a vertebra slips out of its normal position and comes to rest on the vertebra beneath it. Whether due to an acute injury or gradual spinal degeneration, spondylolisthesis can become crippling if it’s not promptly addressed.

This article will explore key spondylolisthesis symptoms, what causes them, and how to alleviate them.

What Are the Signs and Symptoms of Spondylolisthesis?

The signs and symptoms of spondylolisthesis include:

Lower back pain
Pain that extends into the buttocks and/or thighs
Tightness and muscles spasms in the hamstring muscles
Sciatica (nerve pain, numbness, and/or tingling that travels from the lower back through the buttocks and down one leg)

In many cases, spondylolisthesis is asymptomatic, meaning that it doesn’t cause any symptoms. This usually occurs if the misaligned vertebra doesn’t press on any nearby nerves or other soft tissues.

What Is the Most Common Cause of Spondylolisthesis?

The most common cause of spondylolisthesis in adults is age-related spinal degeneration. In children and teens, the most common cause of spondylolisthesis is a vertebral stress fracture.

The aging process and day-to-day strain on the body take a toll on the spine. The cartilage that protects the spinal joints gradually wears away, leading to increased impact on the spinal structures. Additionally, the shock-absorbing spinal discs that protect the vertebrae thin and dry out with age, leaving the vertebrae vulnerable to damage.

Stress fractures from overuse account for most cases of spondylolisthesis in kids and teens. This injury is more common in athletes such as gymnasts, football players, and divers. A vertebral stress fracture can cause instability in the spine, causing the affected vertebra to slip out of position.

Other Causes of Spondylolisthesis

Not all cases of spondylolisthesis are caused by degeneration or overuse. Other possible causes of spondylolisthesis include a sudden impact on the spine and genetic factors.

If the spine is subject to a sudden force, such as an auto accident, a vertebral fracture may occur. This is sometimes referred to as traumatic spondylolisthesis, and it’s relatively rare.

When spondylolisthesis is triggered by genetic factors, it’s typically called congenital spondylolisthesis. This condition develops when the spine doesn’t develop properly in the womb. Patients are born with this condition and may start to experience symptoms in childhood.

What Is the Best Test for Spondylolisthesis?

CT scans are widely considered to be the best test for diagnosing spondylolisthesis. CT stands for computed tomography.

This type of diagnostic test uses X-ray technology to create detailed images of the body. It’s the gold standard for diagnosing spondylolisthesis because it displays the bones in greater detail than other tests.

CT scans and X-rays are easily confused. However, while a single beam of energy is directed at the affected body part during an X-ray, an X-ray beam travels in a circular motion around the body during a CT scan. As a result, a CT scan offers multiple angles of the body part, while an X-ray produces just one.

Many cases of spondylolisthesis can be successfully diagnosed with a simple X-ray. But, to gather more information about the affected vertebrae and diagnose complex spondylolisthesis cases, CT scans are preferred. If spondylolisthesis causes significant damage to surrounding tissues, an MRI scan may also be used for its superior soft tissue contrast.

What Is the Best Treatment for Spondylolisthesis?

The best treatment for spondylolisthesis is physical therapy and lifestyle adjustments. To cure the condition in advanced cases, decompressive laminectomy with a form of stabilization is the best surgical treatment option.

Physical Therapy for Spondylolisthesis

Physical therapy is a drug-free treatment that focuses on improving body mechanics, alleviating muscle tension, and boosting support for the spine. Your physical therapist can prescribe a variety of spondylolisthesis exercises to enhance the strength of your core and back muscles. This will reduce the strain on your spine with day-to-day motions and allow the painful tissue to heal.

Your physical therapist may also implement treatments like heat/cold therapy, massage, electrical stimulation, and ultrasound therapy. These methods help spondylolisthesis patients manage inflammation and pain.

Other Non-Surgical Spondylolisthesis Treatments

Physical therapy isn’t the only conservative treatment method used to manage spondylolisthesis symptoms. Other options include:

Lifestyle modifications, like avoiding activities that strain the spine
A brace to stabilize the spine (this treatment is only used in children and teens with spondylolisthesis)
Pain medications, including over-the-counter anti-inflammatory drugs (such as NSAIDs) and prescription muscle relaxants
Epidural steroid injections, which relieve pain in the spine reducing the immune response in the affected area, which in turn reduces inflammation

It’s important to know that medications, including steroid injections, come with various risks and possible side effects. Talk to your doctor about all of the medications you’re currently taking before starting a new drug. Additionally, medications aren’t considered a long-term solution to spondylolisthesis, as they can only alleviate the patient’s symptoms – not address the condition’s root cause.

Surgery for Spondylolisthesis

When conservative spondylolisthesis treatments don’t offer symptom improvement after several months, your physician may recommend surgery. Decompressive laminectomy, as we mentioned above, is widely used for spondylolisthesis with a form of stabilization. Laminectomy involves removing the lamina to alleviate nerve compression caused by the displaced vertebra.

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Given that spondylolisthesis causes spinal instability, decompressive surgery is rarely used alone. Conventionally, surgeons have used spinal fusion to stabilize the spine after decompression surgery. Fusion involves placing bone graft material between the afflicted vertebra so that they fuse into one bone.

Unfortunately, spinal fusion can cause limited mobility and adjacent segment degeneration in spondylolisthesis patients (not to mention an extensive recovery process). Non-fusion implants like the revolutionary TOPS System can stabilize the spine after surgical decompression without jeopardizing the patient’s mobility.

Patients suffering from spondylolisthesis symptoms should speak with an experienced spinal specialist to learn about the complete range of treatment options available to them.

Spondylolisthesis

L4-L5 Spondylolisthesis

November 3, 2022 by User_01 Sortino Marketing

The L4-L5 segment is the most flexible part of the lumbar spine. Though this flexibility is crucial to carry out basic movements, it also makes the L4-L5 more susceptible to certain spinal conditions, including spondylolisthesis.

In this article, we’ll go over the most common questions about L4-L5 spondylolisthesis and explain the treatment options available for this prevalent spinal condition.

What is Spondylolisthesis at L4 L5?

L4-L5 spondylolisthesis is most often caused by spinal degeneration. With age, the spinal structures naturally weaken and break down. This can compromise the stability of the spine and trigger the vertebral slippage associated with lumbar spondylolisthesis.

Spondylolisthesis develops when a vertebra slips out of its normal position and settles on the vertebra beneath it. This occurs as a result of spinal instability.

L4 and L5 are the lowest lumbar vertebrae. The lumbar (lower) spine is the most susceptible to injury because it’s particularly flexible and bears more impact than the upper or middle spine. With this in mind, the L4-L5 segment is the second most common area for spondylolisthesis (L5-S1 is the most common segment).

What Are The Symptoms of L4-L5 Nerve Damage?

L4-L5 nerve damage can cause symptoms including:

Sharp pain that starts in the lumbar spine and travels down the leg
Numbness in the lower extremities, including the leg, foot, or toes
Weakness in the leg when you move
Tingling or a pins-and-needles feeling that travels from the lower back down the leg

Nerve pain that moves from the lumbar spine to the buttocks and down the back of a leg is generally labeled sciatica. The sciatic nerve runs from the lower back to the hips and buttocks, then down each leg.

Various factors can cause sciatica flare-ups, including stress, excess weight, wearing unsupportive shoes, and poor posture. If you experience sciatica symptoms with L4-L5 spondylolisthesis, you’ll benefit from stress management, weight management, wearing supportive shoes, and practicing good posture to avoid flare-ups.

Can L4 and L5 Spondylolisthesis Cause Hip Pain?

Damage to L4 and L5, including spondylolisthesis, can lead to hip pain. This is because the misaligned vertebrae can press on nerves that extend through the hips. When these nerves become irritated, inflamed, or damaged, the patient may experience significant hip and leg pain.

Can You Be Paralyzed From Spondylolisthesis?

Spondylolisthesis can cause paralysis if it’s left untreated for an extended period. Specifically, without the proper treatment, spondylolisthesis can cause serious nerve damage, which can lead to paralysis.

Cauda equina syndrome is a possible complication of L4-L5 spondylolisthesis that presents a high risk of paralysis. The cauda equina is a group of nerves and nerve roots at the lumbar end of the spinal cord. Cauda equina syndrome develops when nerve roots in the cauda equina become compressed, presenting a risk of bowel and/or bladder dysfunction, as well as paralysis.

To prevent permanent nerve damage and disability, it’s essential to seek out immediate medical care for cauda equina syndrome. Warning signs to look out for include:

Saddle anesthesia, which is numbness and lost sensation in the buttocks, inner thighs, and the perineum
Weakness and periodic changes in sensation (i.e. numbness) in the lower limbs
Bowel and/or bladder dysfunction
Unexplained sexual dysfunction
Referred pain (pain felt at an area of the body other than its origin)
Impaired tendon reflexes

Can I Go To The Gym With Spondylolisthesis?

Most patients can go to the gym with spondylolisthesis, but it’s important to avoid exercises that may strain the spine. Additionally, you should check with your doctor before exercising if you’ve been diagnosed with spondylolisthesis.

Exercises that are typically safe to perform at the gym with spondylolisthesis include:

Walking on the treadmill
Using the elliptical machine
Completing gentle strengthening exercises, including pelvic tilts and curl-ups
Gently stretching
Doing yoga (while omitting positions that strain the spine)

Exercises to avoid at the gym if you’ve been diagnosed with spondylolisthesis include:

Running on the treadmill
Weightlifting
Using the back extension machine
Box jumps
Jumping rope
HIIT workouts

What Are The Treatment Options for L4-L5 Spondylolisthesis?

A broad array of treatment options is available for L4-L5 spondylolisthesis, including:

Physical Therapy

Physical therapy is widely regarded as one of the most effective non-invasive treatments for L4-L5 spondylolisthesis. The goal of PT for spondylolisthesis is to strengthen the muscles that protect the spine, promote mobility, and prevent further injury.

Your physical therapist may recommend both passive and active treatments for spondylolisthesis. Passive treatments, like massage, heat/cold therapy, and electrostimulation therapy, help alleviate muscle tension and promote healing.

Active physical therapy methods typically include targeted exercises recommended specifically for your needs.

Pain Medication

Certain medications can help with the symptoms of lumbar spondylolisthesis:

NSAIDs
Neuropathic agents
Muscle relaxants
Corticosteroids

Lifestyle Adjustments

Making specific lifestyle adjustments can help you recover from L4-L5 spondylolisthesis:

Avoiding high-impact exercise and activities that may strain the spine
Quitting smoking and using nicotine products, which reduce the flow of blood, oxygen, and nutrients throughout the body
Practicing good posture, which reduces unnecessary strain on the spinal structures
Getting plenty of sleep each night so that your body has a chance to rest and recover

Bracing

Since spondylolisthesis involves spinal instability, wearing a brace can help prevent pain and neurological symptoms. The brace will help keep your spine in the proper alignment and can help heal a fracture in the pars interarticularis.

Spinal Surgery

Although most cases of spondylolisthesis can be resolved with conservative treatments, surgery may be required in severe cases. Generally, physicians don’t recommend spondylolisthesis surgery unless the patient has undergone six to 12 months of conservative therapies and still experiences chronic, debilitating symptoms.

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Spinal fusion is the most commonly done procedure for spondylolisthesis. This operation involves fusing the affected vertebrae with bone graft material. In the weeks and months after the procedure, the vertebrae will become a single bone.

For spondylolisthesis patients, spinal fusion can permanently correct the slippage of the vertebra. Unfortunately, it also limits mobility and poses the risk of future degeneration in the adjacent spinal segments.

Alternatives to spinal fusion like the TOPS System can help spondylolisthesis overcome their symptoms without losing spinal mobility. The TOPS System is a non-fusion mechanical device implant that stabilizes the affected vertebrae and recreates the natural motion of the spine. Additionally, it’s designed specifically to be used at a single level between L2 and L5.

To learn more about the available treatments of L4-L5 spondylolisthesis, contact a medical provider in your area today.

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Spondylolisthesis

How I Cured My Spondylolisthesis Naturally?

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Is Natural Treatment of Spondylolisthesis Possible?

Can Spondylolisthesis Heal Itself?

How Long Does Spondylolisthesis Take to Heal?

What Should You Not Do With Spondylolisthesis?

Does Sitting Aggravate Spondylolisthesis?

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The Importance of Timely Doctor Appointments in Spondylolisthesis Treatment

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Is Surgery for Lumbar Spondylolisthesis Permanent?

Surgery Options for Severe Grades of Spondylolisthesis

Spinal Fusion Alternatives For Spondylolisthesis

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How To Sleep If You Have Spondylolisthesis?

Does Sitting Cause Spondylolisthesis Pain?

What Worsens Spondylolisthesis?

What About Asymptomatic Spondylolisthesis?

How To Sit Comfortably With Spondylolisthesis?

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How is Surgery Used To Relieve Spondylolisthesis Pain?

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How To Stop Spondylolisthesis Pain?

What Part of the Spine Is Spondylolisthesis?

Table of Contents

Where Is Spondylolisthesis Located?

Symptoms of Severe L5-S1 Spondylolisthesis

Is Spondylolisthesis Always L5 S1?

Degenerative vs. Isthmic Spondylolisthesis

Why is Spondylolisthesis Common at L4-L5?

What Is Grade 1 Spondylolisthesis L4 L5?

How Do You Treat Grade 1 Spondylolisthesis of L4 L5?

Grade 2 Spondylolisthesis L4 L5

Grade 3 Spondylolisthesis L4 L5

Grade 4 Spondylolisthesis L4 L5

Grade 5 Spondylolisthesis L4 L5

Determining Spondylolisthesis Grade and Location

Surgery for Spondylolisthesis of L4-L5

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Spondylolisthesis Surgery Overview

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How Spondylolisthesis Surgery Is Made

Is Spondylolisthesis Surgery a Major Surgery?

What Is the New Surgery for Spondylolisthesis?

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What Is the Success Rate for Spondylolisthesis Surgery?

What Affects the Success Rate of Spondylolisthesis Surgery?

What’s the Rate of Complications in Spondylolisthesis Surgery?

Is Surgery Worth It for Spondylolisthesis?

Signs That Spondylolisthesis Surgery May Be Worth it For You

Is Spondylolisthesis Surgery Safe?

What Is the Age Limit for Spinal Surgery?

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Spinal Stenosis

Paralysis

Spinal Deformities

What Is the Best Choice for Spondylolisthesis Surgery?

​​Spondylolisthesis in Children and Adolescents

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How Does Spondylolisthesis Occur in Adolescents?

Symptoms of Spondylolisthesis in Children and Adolescents

What Is the Most Common Type of Spondylolisthesis in Children?

What Is the Most Common Age for Spondylolisthesis?

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Which Sports Cause Spondylolisthesis?

Is Spondylolisthesis Common in Children?

How Is Spondylolisthesis Diagnosed in Children and Adolescents?

How Is Spondylolisthesis Treated in Children and Teens?

Activity Modifications

Bracing

Physical Therapy

Pain Medications

When is Surgery Required for Spondylolisthesis in Kids and Teens?

Grade 1 Spondylolisthesis: Causes, Treatments, Recovery Forecasts

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Spondylolisthesis in Children and Adolescents