After undergoing surgery for lumbar spondylolisthesis surgery, the body needs time to heal and recover. An important aspect of this recovery process is physical therapy.
Physical therapy can greatly improve your recovery process from lumbar spondylolisthesis surgery. By reducing inflammation, tension, stiffness, and pain, this therapeutic practice will help you heal from spondylolisthesis.
This article will dive into the topic of lumbar spondylolisthesis, its signs and symptoms, and what to expect from surgery. We’ll also discuss the TOPS system, a compelling alternative to spinal fusion in lumbar spondylolisthesis surgery.
Spondylolisthesis affects approximately 4% to 6% of adults. This spinal disorder impacts the vertebrae, which are the bones of the spine. Lumbar spondylolisthesis affects the lower (lumbar) spine and is one of the most common forms of the condition.
With lumbar spondylolisthesis, one of the spine’s vertebra slips out of its regular position. The bone then settles on the vertebra directly below it. Although some patients experience no symptoms from this condition, it typically causes:
Most often, lumbar spondylolisthesis is caused by overstretching the spine. Genetics, age, and certain lifestyle factors can increase your risk of developing the condition.
Older adults are at a higher risk of developing spondylolisthesis due to age-related spine degeneration. However, adolescents can also get this condition as a result of rapid growth.
Athletes are at a higher risk of straining the lower back. In particular, regularly participating in gymnastics, weight lifting, football, and running can heighten your risk for lumbar spondylolisthesis.
Patients with spondylolisthesis are usually started out on a non-surgical treatment plan. There are a variety of non-surgical treatment methods that can provide relief from symptoms of this spinal condition, including:
Especially for athletes and people with physically demanding jobs, rest can ease pain and inflammation from spondylolisthesis.
Physical therapy for spondylolisthesis can reduce stress on the spine and ease the pain with targeted exercises and pain management methods.
Over-the-counter medications can reduce pain and inflammation from spondylolisthesis. Your doctor may also prescribe medications to help manage your symptoms.
Patients who don’t respond to non-surgical treatment options may need to consider surgery. Surgery for lumbar spondylolisthesis can relieve persistent pain and re-establish the function of the spine.
Surgery for lumbar spondylolisthesis is focused on relieving pain and stabilizing the spine so that the vertebrae are less likely to slip out of place. To achieve this goal, doctors generally perform decompression surgery with spinal fusion.
In decompression surgery, your surgeon will create extra room in the spinal canal. This can relieve stress on nerves that are irritated from spondylolisthesis.
Spinal fusion is a surgical procedure that involves fusing two spinal bones together. Over time, the vertebrae gradually connect to form one bone.
Although spinal fusion can prevent the instability associated with lumbar spondylolisthesis and help you heal, it compromises the patient’s range of motion in the back. After spinal fusion, patients may no longer be able to bend down to pick up objects and perform other motions as they could before the procedure.
Spinal fusion also has a lengthy recovery period. Patients may need to remain in the hospital for a few days after the surgery, and it can take months to complete the recovery process.
The TOPS System is a spinal implant that can take the place of spinal fusion for patients with lumbar spondylolisthesis. This device stabilizes the spine but moves with the body, ensuring that patients retain spinal flexibility after the procedure. Additionally, the TOPS spinal implant can dramatically reduce patients’ recovery times when compared to spinal fusion.
After lumbar spondylolisthesis surgery, doctors typically recommend that patients undergo physical therapy. Physical therapy can improve your recovery from the procedure by helping to restore spinal flexibility, strengthen muscles that bolster the spine, and promote spinal alignment for lasting pain relief.
Typically, patients are recommended to start physical therapy a month to a month and a half after spondylolisthesis surgery. Keep in mind that everyone progresses at different rates after this procedure. Your physical therapist will tailor your routine to your body’s unique needs.
Additionally, it’s important for your physical therapist to continually monitor your progress before introducing new exercises or activities to ensure that your body heals properly. A re-injury is a serious setback for the healing process.
The key components of physical therapy after lumbar spondylolisthesis surgery include:
Especially in the early stages of recovery for spinal surgery, pain-relieving treatments are a major part of physical therapy. These treatments may include massage, ultrasound, heat and cold therapy, and transcutaneous electrical nerve stimulation (TENS). Pain-relieving methods can alleviate pain, tension, inflammation, and muscle spasms.
After spondylolisthesis surgery, one of the key goals is to stabilize and strengthen the spine’s supporting muscles to ward off re-injury. Your physical therapist will work with you one-on-one to teach and assist with a variety of strengthening exercises.
Your post-operative training with a PT may involve:
Exercises such as intensive weight lifting and endurance exercises are generally avoided for several months after surgery.
Your physical therapist will gradually introduce more strenuous and challenging exercises over time. It typically takes around three to five months after surgery for spondylolisthesis for patients to advance their training to include resistance training, weight machine exercises, and intensive cardiovascular training.
After recovering from spinal surgery, patients will need to be particularly cautious for overhead lifting. Overhead lifting can compress the spine and poses a major risk of injury in spondylolisthesis patients.
In addition to providing exercises and passive treatments, your physical therapist can recommend an exercise routine to guide you throughout the recovery process. Exercise is an essential part of healing after a spinal procedure.
Your physical therapist may recommend that you try aquatic therapy as you recover from spinal surgery. Performing various exercises in the pool reduces the impact on your spine. This can help you recover from the procedure while preventing injuries.
Approximately five months to a year after spinal surgery, the goal of physical therapy is to restore your body to a pre-spondylolisthesis state. During this late period in the recovery process, patients generally follow a home conditioning program as recommended by their physical therapist.
If spinal fusion was performed during spondylolisthesis surgery, patients may experience pain or mobility issues above and below the fused vertebrae. For these patients, ongoing physical therapy and spinal care may be required to prevent complications.
Many people in the US and across the world suffer from Spondylolisthesis which can cause ongoing back pain and neck pain. Although it is not considered a serious ailment and many people can work and live a normal life while suffering from the condition, it is obviously an unwanted condition and the pain can result in stress and prevent a person from doing numerous activities.
In this FAQ we will look at the various treatment options and how to adjust your lifestyle for faster recovery from Spondylolisthesis treatment surgery.
What is Spondylolisthesis?
Spondylolisthesis is a condition when one of the vertebrae (bones in the spine) moves out of its natural position, causing pain and discomfort. This usually occurs in the lower back but this has also been known to happen in the mid-to-upper back, the top of the spine, or the back of a person’s neck.
The condition is not to be confused with a slipped disc, as this refers to the tissue between the bones in the spine.
Symptoms of Spondylolisthesis
Symptoms of Spondylolisthesis can range in their severity but the most common signs are:
It is recommended to pay a visit to your local doctor if any of these symptoms persist, who can diagnose the problem correctly and direct you in terms of the next course of action.
The main causes of Spondylolisthesis
There are many causes of Spondylolisthesis which can include;
Can I get non-surgical treatment for Spondylolisthesis?
There are numerous Spondylolisthesis treatments that can be tried before going down the route of surgery which would require a lengthy period of rest. These treatments can range from simple measures to medication, and therapy.
Taking as much rest as possible and avoiding activities that could put additional strain on your back, such as sports, is of course the easiest way to relieve the symptoms of Spondylolisthesis.
There is also a range of medications that you could try to ease the pain and discomfort of the condition – recommended medication can include nonsteroidal anti-inflammatories like Ibuprofen or Naproxen.
If this medication is not effective then the next step may be steroid injections into the area which is causing pain.
Alternatively, a person suffering from Spondylolisthesis may also attend physical therapy which can help strengthen your back and abdomen. Exercising each day can be a great way to relieve pain in the long term.
For children and younger people, using a back brace can also help to provide stability to your spine as it limits sharp movements, helping the damaged vertebrae to heal.
Can I have surgery for Spondylolisthesis?
If you are not seeing the desired results following Degenerative Spondylolisthesis treatment then the next option would likely be surgery.
Surgery would be recommended if your condition persists for a long period of time and the pain becomes severe. The most common form of surgery would be Spinal Fusion Surgery and as the name suggests, this involves fusing the slipped bone to the adjacent bones using metal screws and rods, in addition to a small section of bone taken from elsewhere in the body. The screws and rods usually remain inside the body on a permanent basis.
Another method is to remove the disc (tissue) between the slipped bones and replace it with a mechanical implant device, also consisting of a bone graft that will ensure the vertebrae are kept apart and no longer cause discomfort. A general anesthetic would be used for this surgery, and the one above, therefore the patient would not be conscious.
Back surgery is of course a form of major surgery and the patient is likely to remain in the hospital for around a week after the procedure. It should also be noted that any surgery of this kind does run the risk of complications.
Spinal fusion surgery for degenerative Spondylolisthesis has a very high success rate, with over 90% of patients reporting improved functionality and a significant decrease in pain levels.
How long does it take to recover from Spondylolisthesis surgery?
The recovery time from spinal and Spondylolisthesis surgery can take a number of months and during this time you would need to avoid strenuous activities, especially sports. This could be a significant issue for anyone who works in an especially manual job.
Can Spondylolisthesis be reversed?
Unfortunately, Spondylolisthesis cannot be completely reversed but the symptoms can be relieved greatly, to the point where they are not even noticeable. Treatments for example could provide long-term pain relief but will do nothing to repair the slip, or crack itself.
Whereas surgery would provide stability to the spine and relieve any pressure on the nerves, ultimately helping the patient regain strength in their back.
Lifestyle changes to speed up Spondylolisthesis surgery recovery
Below are six ways to help speed up back surgery recovery times:
We hope this article has been of use and answered any questions you may have.
What Is Spondylolisthesis?
Spondylolisthesis is a disorder in which one vertebral body slips from the adjacent vertebral body. As an effect, there might appear radicular or mechanical symptoms. An affected person can feel pain and discomfort. The cause can be acquired, idiopathic, or congenital. Depending on the degree of slippage, a doctor can grade your spondylolisthesis. To do this, medical experts use the Meyerding Classification.
The Meyerding Classification divides levels of spondylolisthesis into five grades. The location of the posteroinferior corner of the vertebra above influences the grade.
Spondylolisthesis can cause various symptoms that can help to diagnose this disorder. Some of them include:
Spondylolisthesis Physical Therapy
Physical therapy is one of the most effective and non-invasive methods that can help you with your issue. Particular exercises performed under the eye of a professional can help you to strengthen the muscles that support the spine. You can also learn how to take care of your spine and prevent injuries in the future.
Types of Physical Therapy
There are two types of treatment of spondylolisthesis: passive and active.
Passive treatments allow patients to relax and release the muscles in the body. As the name suggests, you don’t have to actively participate in the process. It is a perfect solution for people who suffer from tremendous pain and have advanced problems. The passive treatment can prepare you and your body for further steps in the process of recovery.
The goal of passive treatments is to get you into the active one. Active treatments are exercises that can strengthen your body and help to prevent recurring pain from spondylolisthesis.
Examples of Passive Treatments
Hot and Cold Therapies
This therapy uses hot and cold in intervals or uses just one of the two treatments. By using heat, you get more blood to the targeted area. Increased blood flow means that more oxygen and nutrient go to the heated area. Blood can also help with removing byproducts that were created by muscles spasm.
Cryotherapy, cold therapy, can slow circulation. Thanks to that, inflammation, muscle spasms, and pain can be reduced. Common ways to use cold therapies are by using a cold pack on the affected area, cold spray, or massages with the use of ice. After performing cryotherapy, your physician might want you to stretch the affected area.
Deep Tissue Massage
When your body readjusts to the slipped vertebra, your muscles can build up a lot of tension. A deep tissue massage allows to reach those muscles and release them. Your therapist can use direct pressure on the affected area to release the tension in soft tissues.
Transcutaneous Electrical Nerve Stimulation (TENS)
During this therapy, you are going to be connected to a machine that stimulates your muscles using electricity. The whole process is totally safe. TENS reduces muscle spasms and tension. Because of that, it can also trigger your organism to produce endorphins. This hormone can, in a natural way, reduce your pain.
TENS machines used in physical therapists’ offices are quite large, but if you would like to continue treatment at home, you can find smaller machines.
An ultrasound is a great way to reduce muscle cramping and spasms. It can also eliminate swelling and stiffness of the affected area, releasing pain. Ultrasound waves travel deep into your muscles and generate heat. As an effect, your blood starts circulating faster and the process of healing starts.
Once your pain eases a bit, your physical therapist can show you exercises that can improve your strength, flexibility, range of motion, and stability. Your therapist is going to interview you to know more about your health and history. They are also going to consider your physical abilities before programming exercises for you.
During therapy, your physician might teach you how to keep a correct posture and incorporate it into your daily life. Through the practice, you not only get better but also learn good habits that can help you to prevent injuries in the future.
Your therapist can recommend a set of exercises to you that you should follow even after therapy. This way, the risk of getting recurring back pain is lower. Moreover, you improve your overall health. If you suffer from spondylolisthesis, you can expect exercises that strengthen your abdominal and hamstring. Those two muscle groups are very important for low back support and can prevent lumbar spondylolisthesis from developing.
Isotonic and isometric activities can strengthen the main muscles of the chest. The stronger is the trunk, the better is the spine’s stability. Those types of exercises are also for reducing pain. Another great way to get rid of pain is performing endurance training of muscles.
Core exercises are useful in easing pain. They can reduce chronic pain in patients with spondylolisthesis. A stable core also means more support for the spine.
Stretching and strengthening exercises can help to decrease the force which the lumbar spine has to carry. Activities that involve hamstrings, lumbar paraspinal muscles, and hip flexors are crucial to improving the patient’s mobility.
Some of the other most common active exercises recommended for spondylolisthesis are:
Remember that some exercises can be great for some people, but not necessarily good for you. Before performing any of the mentioned activities, consult your doctor or physical therapist to verify if you can benefit from them and if they are safe for you.
Depending on the grade of your spondylolisthesis, you might need to adjust the level of exercise. The best way is to seek the help of a professional. After a few sessions, you might be able to perform all the exercises on your own, without the risk of hurting yourself.
In case the physical therapy is not effective, you might need spondylolisthesis surgery.
There is no one type of surgical treatment that suits all patients. Some of the most common treatments include decompression, fusion with instrumentation or without it, and interbody fusion. In some cases, these treatments can be combined.
Some surgeons recommend reducing spondylolisthesis. This way, the foraminal narrowing can be decreased. Moreover, spinopelvic sagittal alignment can improve. All of this creates a lower risk of further spinal changes. The higher the grade of spondylolisthesis, the bigger is the risk of the operation.
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:
Those are the most common reasons for spondylolisthesis, but here are some less common ones:
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:
Slipped Vertebrae Symptoms
Slipped vertebrae lower back symptoms can be severe, but some people don’t experience any issues. You may notice:
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:
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:
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.