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.
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.
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.
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.
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.
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.
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:
Certain forms of exercise can lead to spondylolisthesis progression and worsened symptoms. These include:
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.
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.
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.
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:
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.
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.
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.
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.
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.
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.
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.
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.
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).
L4-L5 nerve damage can cause symptoms including:
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.
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.
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:
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:
Exercises to avoid at the gym if you’ve been diagnosed with spondylolisthesis include:
A broad array of treatment options is available for L4-L5 spondylolisthesis, including:
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.
Certain medications can help with the symptoms of lumbar spondylolisthesis:
Making specific lifestyle adjustments can help you recover from L4-L5 spondylolisthesis:
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.
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.
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.
Have you heard of spondylolisthesis? This prevalent spinal condition comes on when a vertebra slips out of its proper position. The vertebra settles on the spinal bone beneath it and may press on nearby nerves, leading to back pain and neurological symptoms.
In its more severe forms, spondylolisthesis can require surgery. Patients who must undergo spondylolisthesis surgery often seek out ways to improve the recovery process, which can be lengthy and uncomfortable.
This article will cover topics relating to spondylolisthesis surgery recovery, including tips for accelerating the healing process.
Most spine specialists use a grading system known as Meyerding’s classification of spondylolisthesis to evaluate this spinal condition. According to this system, the grades of spondylolisthesis include:
Patients with grade 3 or grade 4 spondylolisthesis typically don’t experience improvement with conservative treatments alone. For these grades of spondylolisthesis, surgery is often required for lasting symptom relief.
Spondylolisthesis surgery most often consists of spinal decompression and fusion. Spinal decompression, such as a laminectomy, can alleviate nerve compression caused by spondylolisthesis. Fusion is used to avert spinal instability.
During a laminectomy, which is a common form of spinal decompression used for spondylolisthesis, the surgeon will first access the affected vertebrae through an incision. If the surgeon opts to use minimally-invasive techniques, they’ll likely use specialized tools including real-time X-ray technology and an operating microscope.
Once the surgeon has accessed the spine, they can remove some or all of the lamina to alleviate nerve impingement. This is the piece of bone that covers the back of the spinal canal.
To perform spinal fusion, the surgeon will need to place bone graft material in between the targeted vertebrae. This will stimulate the fusing of the vertebrae over the course of several months. Once this process is complete, the vertebrae will be permanently fused, with all motion eliminated at that spinal segment.
The length of time that spondylolisthesis surgery takes to complete depends on the surgical approach. Minimally-invasive spine surgery, which involves a smaller incision, is typically shorter than traditional spine surgery.
Traditional spinal fusion surgery can span between two and seven hours, depending on various factors. In most cases, this procedure takes approximately four hours.
Minimally-invasive spinal fusion, on the other hand, typically only takes one to two hours. However, if it involves two spinal levels, it may take around three hours.
Your spine surgeon can provide a time estimate for the spondylolisthesis procedure that you’ll receive.
Spinal fusion reduces patients’ mobility and can lead to the degeneration of adjacent spinal segments. Known as adjacent segment disease, or ASD, this occurs because the neighboring segments must bear added impact to compensate for the fused vertebrae.
With these and other downsides, spondylolisthesis patients would often prefer to avoid spinal fusion altogether. Thanks to advancements in medical technology, spinal fusion alternatives are now available to patients.
One option is the TOPS System, which is a unique non-fusion mechanical implant device for lumbar spondylolisthesis and spinal stenosis. It’s secured to the affected vertebrae to provide stability with a controlled range of motion.
To prepare for spondylolisthesis surgery, you’ll need to organize your home, talk to your loved ones, and follow all of your physician’s instructions. Here are our top tips:
With a few simple tips, you can recover faster from spondylolisthesis surgery.
The goal of spondylolisthesis surgery is to resolve the misaligned vertebrae through spinal decompression and stabilization. So, if the surgery is successful, it should resolve your symptoms.
Spondylolisthesis surgery is typically successful. The latest non-fusion spine devices and minimally-invasive surgical techniques can further reduce the risks associated with the procedure.
To learn if you’re a good candidate for spondylolisthesis surgery, contact a qualified spine specialist in your area.
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.
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 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 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.
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.
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.
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.
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.
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.
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.
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.
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.
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 can cause lasting pain, stiffness, and neurological symptoms. In some cases, this spinal condition can diminish patients’ mobility and ability to carry out day-to-day tasks. So, many spondylolisthesis patients wonder whether or not the condition can be reversed.
In this article, we’ll discuss how long spondylolisthesis typically lasts and whether or not it can be cured.
Spondylolisthesis occurs when one of the spinal bones, called vertebrae, slips out of its normal position. The misplaced bone rests on the vertebra beneath it, often causing significant lower back pain.
Technically, there’s no cure for spondylolisthesis. Non-surgical treatment methods can’t resolve the slippage of the vertebra but can be successful in alleviating patients’ symptoms. Surgery can be used to fix the misplaced vertebra.
The time that it takes to make a full recovery from spondylolisthesis depends on the patient’s age and the case’s severity. In most young patients, the condition heals within three to six months of non-surgical treatment. While these methods (such as physical therapy) won’t bring the misplaced bone back to its proper position, they can be effective at alleviating patients’ symptoms.
For older individuals, it may take longer to recover from this lumbar spine condition. If you undergo surgical treatment for spondylolisthesis, the recovery process may last for up to a year (particularly for spinal fusion). Opting for a non-fusion spinal device can shorten this recovery period.
Several lifestyle factors can worsen spondylolisthesis and inhibit your recovery process. These factors include:
Standing, sitting, or exercising with poor posture keeps the spine misaligned. When the spine is out of alignment, it undergoes additional strain when you sit, stand, and walk.
Smoking cigarettes, e-cigarettes, cigars, or using any other nicotine can worsen spine conditions like spondylolisthesis. Nicotine is a blood vessel constrictor, so it limits the flow of blood throughout your body. As a result, your spine doesn’t receive the oxygen and nutrients that it needs to remain healthy.
Excess pounds add stress to the spine. Whenever you stand, sit, or walk, your spine must bear the extra weight, which can speed up the process of spinal degeneration.
High-impact activities like running, jumping, diving, gymnastics, and contact sports can worsen spondylolisthesis. These activities can force the spine into positions that worsen nerve compression and pain. They also heighten the risk of further injury.
Adjusting your lifestyle to avoid these factors is an important aspect of how to cure spondylolisthesis.
Most cases of spondylolisthesis can be treated naturally, without the need for surgery. In these cases, spine specialists may implement spondylolisthesis treatment options including:
Given that spondylolisthesis concerns spinal instability, it can benefit from bracing. A back brace can support the lumbar spine to prevent worsening pain and nerve compression. It can also help keep the spine in alignment while you’re moving around throughout the day.
Physical therapy is widely used as a treatment for spondylolisthesis. Physical therapists specialize in spondylolisthesis treatment exercises to improve both strength and mobility while correcting improper movement patterns.
Ultimately, physical therapy can help reduce the strain on your spine throughout the day. This gives the spine a better chance to heal while lessening back pain and neurological symptoms. Your physical therapist may also implement heat or cold therapy, electrical stimulation, acupuncture, massage, and related techniques to further improve your symptoms.
Your physician may recommend six to 12 weeks of physical therapy for spondylolisthesis. Patients may need ongoing physical therapy to continually manage their symptoms or fully recover from spondylolisthesis surgery.
We’ve already mentioned that high-impact activities may worsen spondylolisthesis pain. However, low-impact physical activity can benefit this condition.
Activities like walking short distances, water aerobics, and tai chi improve circulation, muscle strength, and flexibility. In the long run, a low-impact exercise plan can support your spondylolisthesis recovery.
Spondylolisthesis patients tend to have swelling in the soft tissues around the spine. This inflammation can worsen with day-to-day motions and exacerbate spondylolisthesis symptoms. So, your physician may recommend anti-inflammatory medications to manage the swelling and reduce your pain.
While the non-surgical treatments listed above can help spondylolisthesis patients overcome their symptoms, they can’t physically reverse this spinal condition.
Unfortunately, non-surgical treatments can’t return the displaced vertebra to its proper position. These therapies can only work to alleviate symptoms. So, in severe spondylolisthesis cases, surgery may be the only viable option to restore patients’ comfort, mobility, and function.
To surgically cure spondylolisthesis, spine surgeons typically perform spinal decompression and spinal fusion.
Spinal decompression is a surgical technique with the goal of releasing pressure on the nerves in the spinal canal. It may be implemented when a misplaced vertebra caused by spondylolisthesis presses on spinal nerves.
A few different methods of surgical spinal decompression exist, including laminectomy, foraminotomy, and discectomy, among others. Your spine surgeon will select the best approach for your case. However, laminectomy is one of the most widely used methods for spondylolisthesis, and it creates more space in the spinal canal by removing some or all of the lamina at the back of the spine.
Patients with spondylolisthesis are subject to spinal instability. So, to stabilize the spine, many physicians implement spinal fusion.
During spinal fusion, the surgeon places bone graft material in between two or more vertebrae. This material will gradually cause the vertebrae to fuse into one segment of bone. This prevents all motion at the fused segment.
Though spinal fusion is a trusted procedure for spondylolisthesis, it can severely limit patients’ mobility. Without the ability to move or bend the spine at the fused segment, patients may have to give up some of their favorite physical activities. Thus, modern and innovative medical devices come to help:
So, what is the best treatment for spondylolisthesis? The answer comes down to the patient’s unique needs. Talk to a trusted spine specialist to learn about the treatments available for your spondylolisthesis case, including innovative motion-preserving implants.
The natural aging process has a noticeable impact on the entire body. The spine is included in this process and, as a result, degenerates with age.
Several different spinal conditions can develop as a result of age-related degeneration. Spondylolisthesis is one such condition. It occurs when one of the spinal bones, or vertebrae, slips out of position due to instability. The vertebra then settles on the bone beneath it.
Degenerative spondylolisthesis can be a debilitating condition. The misaligned vertebra may press on the spinal cord, along with the spinal nerves. This can cause persistent back pain and neurological symptoms like weakness, tingling, and numbness.
Spondylolisthesis typically doesn’t require surgery. When it does, spinal fusion is the most long-standing procedure to correct the instability. However, thanks to recent innovations in the field of medicine, patients who must undergo spondylolisthesis surgery can now consider non-fusion surgery to preserve their mobility.
In this article, we’ll explore the topic of non-fusion surgery for degenerative spondylolisthesis and how it may benefit patients suffering from this condition.
Generally, spine specialists have patients undergo non-surgical spondylolisthesis treatments for six to 12 months before even contemplating surgery. Non-surgical therapies for this condition include:
If these methods fail to provide any improvement after several months, surgery may be the next logical step in treatment planning. However, in certain scenarios, your physician may recommend surgery sooner.
For example, if a patient experiences pain from spondylolisthesis that’s debilitating enough to disrupt their capacity to walk, sleep, and carry out other essential day-to-day tasks, surgery may be necessary. Additionally, if spondylolisthesis causes severe nerve compression, surgery may be essential to prevent permanent neurological damage.
Not all patients are good candidates for spondylolisthesis surgery. Though opting for a minimally invasive, non-fusion procedure lowers the overall probability of complications, smoking and being overweight can both put you at risk.
Spinal surgeons may instruct their patients to lose weight and/or quit smoking (or using any product that contains nicotine) before undergoing spondylolisthesis surgery. Making these adjustments will increase your odds of making a full, successful recovery.
To explain whether or not fusion is always required for spondylolisthesis, let’s first consider a brief overview of the grading system for this condition:
Patients who have been diagnosed with grade 3 or 4 spondylolisthesis and don’t improve after six months of non-surgical treatment may need surgery to recover. In the past, spinal fusion was the only option to correct the instability that caused vertebral slippage.
Additionally, degenerative spondylolisthesis patients who develop certain neurological issues may need emergency medical attention. These problems include progressive numbness or weakness in the legs, as well as a new loss of bladder or bowel control. Although these symptoms are rare, they can indicate a risk of permanent nerve damage.
In most cases, the choice to undergo spinal fusion for spondylolisthesis is a personal decision that’s completely up to the patient.
As the name implies, spinal fusion surgery involves permanently fusing two or more vertebrae. The goal of this procedure is to stabilize the spine, often after spinal decompression surgery. Given that spondylolisthesis is triggered by instability, fusion is widely used for spondylolisthesis.
While spinal fusion can successfully resolve instability, it permanently eradicates all movement at the affected segment. So, patients lose mobility in the fused area of the spine. They may lose the ability to bend, twist, flex, and partake in a range of activities.
Additionally, because it involves the healing of bone tissue, spinal fusion requires a lengthy recovery process. It may take up to a year to make a full recovery from this surgical procedure.
Medical innovations have created a new treatment option for patients struggling with degenerative lumbar spondylolisthesis: non-fusion spine surgery. This procedure generally involves the use of a non-fusion implant to stabilize the affected spinal segment without fusing the vertebrae.
Non-fusion implants and artificial disc replacement surgery can provide the following benefits over conventional fusion:
The TOPS System is one implant option for non-fusion lumbar surgery. Designed to be used in the L3 to L5 vertebrae, it works by creating a controlled range of motion in the affected vertebrae. The device provides immediate pain relief and a faster, less painful recovery process when compared to spinal fusion.
Non-fusion spinal decompression surgery is an emerging treatment option for patients with degenerative spondylolisthesis. Talk to your physician today to learn more about this type of procedure and whether or not it could help you overcome debilitating symptoms.
Spondylolisthesis is a potentially debilitating spinal condition. Unfortunately, it can develop at any age and can be caused by a variety of factors.
When spondylolisthesis occurs, it means that one of the spinal bones, known as vertebrae, has slipped out of its normal position. The bone rests on the vertebra directly beneath it.
Several possible treatment approaches exist for spondylolisthesis, most of which are non-surgical. However, in cases of severe spondylolisthesis, surgery is often required.
This article will explore topics surrounding this spinal condition, including the best treatment options for spondylolisthesis.
Many spondylolisthesis cases are asymptomatic. However, patients with symptomatic spondylolisthesis may experience:
One of the most common reasons why young people develop spondylolisthesis is a spinal birth defect. This is known as congenital spondylolisthesis.
With this condition, one of the areas of the spine that controls the motion of the vertebrae (known as articular processes) hasn’t developed properly. As a result, the affected vertebra slips forward onto the vertebra beneath it.
Another key cause of spondylolisthesis is acute trauma to the spine. Though rare, spondylolisthesis can be caused by a fracture in the spinal segment due to direct trauma.
In older individuals, spondylolisthesis often results from wear and tear on the spinal bones. Specifically, spondylolisthesis can result if osteoarthritis (also known as wear and tear arthritis) damages the cartilage in the facet joints of the spine.
The first step in recovering from spondylolisthesis is to stabilize the spine. There are a few non-surgical stabilization strategies that you can implement to alleviate pain and other symptoms. Spondylolisthesis exercises, in particular, are often helpful for strengthening the muscles that stabilize the spine.
Some of the best exercises for spondylolisthesis include:
Start by lying on your back with bent knees and feet flat on the ground. Place your arms by your sides with the palms facing down. Then, while engaging your core, raise one knee to your chest, using your arms for added support. Hold for five seconds, then return to the starting position.
Alternate legs, completing a few sets each morning and night.
Start lying on your back with bent knees and feet flat on the floor. Engage your abdominal muscles while pulling the belly button toward the spine and pressing your lower back to the floor. Hold this position for 15 seconds, keeping your abs engaged.
Repeat 5 to 10 times.
Begin on your hands and knees. Engage your core and pick up one arm and the opposite leg. Stay in this position for 5 seconds before returning to the initial position. Then, repeat with the opposite arm and leg, completing 10 sets in total.
While many exercises, including those listed above, are helpful in healing spondylolisthesis, others are detrimental. Generally, you should avoid weightlifting, high-impact exercise, and exercises that require excessive bending and twisting. Examples of high-impact physical activities are running, football, and basketball.
These activities place excess strain on the spine, which can lead to further damage in spondylolisthesis patients. Your physician can advise you on other activities to avoid with this spinal condition.
Mild spondylolisthesis cases can successfully heal over time with non-surgical therapies. However, patients with more severe forms of the condition may require surgery to make a complete recovery.
Spinal specialists generally recommend that spondylolisthesis patients undergo six months to one year of conservative treatment. If this approach doesn’t produce any improvement, surgery may be considered.
As aforementioned, mild to moderate spondylolisthesis cases are often resolved with non-surgical treatments. These methods are generally preferable to surgery because they don’t involve the risks associated with spine surgery, including:
Studies have found that bracing and exercises that target lumbar extension, range of motion, and strengthening the abdominal and back muscles are the most effective non-surgical therapies for spondylolisthesis. Physical therapists can guide spondylolisthesis patients on the best exercises for their needs.
Other non-surgical treatment options include chiropractic care, acupuncture, massage therapy, electrical stimulation, pain medication, and steroid injections. Lifestyle modifications are also often helpful in speeding up patients’ spondylolisthesis recovery and may include:
The non-surgical therapies mentioned earlier in this article are widely considered the best treatments for spondylolisthesis. However, with cases of spondylolisthesis that don’t respond to these therapies, patients may need to consider surgical treatment.
Laminectomy and/or spinal fusion are the predominant surgical methods used to treat spondylolisthesis. Here’s what you need to know about these procedures:
Laminectomy generally involves removing part of the lamina, which is the section of bone covering the back of each vertebra. By removing a portion of the lamina, your spinal surgeon can alleviate nerve compression in the area caused by spondylolisthesis. However, it’s important to note that the procedure won’t resolve arthritis in cases of degenerative spondylolisthesis.
Laminectomy and other forms of spinal decompression can lead to spinal instability, which is already present with spondylolisthesis. To offset this risk, surgeons often perform spinal fusion.
During spinal fusion, the surgeon places bone graft material in between the afflicted vertebrae. The bone graft will stimulate the fusing of these bones over the next several months.
The fusion process eradicates all motion at the fused spinal segment. This prevents instability, but also holds the patient back from certain movements and activities. The fusion process can also speed up the degeneration of the surrounding segments, which is known as adjacent segment disease or ASD.
Thankfully, spinal fusion is no longer the sole treatment option for spondylolisthesis patients who require surgery. The TOPS System from Premia Spine is a non-fusion implant that can be used to treat lumbar spondylolisthesis and spinal stenosis. As a new, advanced treatment option, it offers an exciting alternative for spondylolisthesis patients facing spinal fusion surgery.
The TOPS System is a mechanical implant device that replaces the spinal tissue that’s extracted during spinal decompression procedures, like laminectomy. It affords the patient a controlled range of motion so that, unlike with spinal fusion, they can partake in a variety of activities.
Patients with spondylolisthesis who haven’t responded to non-surgical therapies should speak to their doctors about every available treatment option. For many, innovative solutions like TOPS can greatly enhance their spondylolisthesis recovery.
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.
To sleep comfortably with spondylolisthesis, you must focus on alleviating pressure on the lower 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.
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.
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.
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.
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.
Aside from spondylolisthesis treatment surgery, several conservative treatment methods can help most patients overcome spondylolisthesis pain. These methods include:
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 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 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.
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.
If you have symptomatic spondylolisthesis, you know that it can cause significant back pain. At times, this pain may be manageable and not interfere with your normal activities. However, when spondylolisthesis flare-ups occur, it may be more difficult to carry out your routine.
Spondylolisthesis becomes painful if the displaced vertebra compresses spinal nerves. When spinal structures press on nearby nerves, it can lead to lower back pain, as well as weakness, numbness, and tingling in the extremities.
However, pain with spondylolisthesis isn’t necessarily a constant problem. In many cases, patients experience pain flare-ups, which are limited periods of more severe pain. These flare-ups are often triggered by specific factors.
Spondylolisthesis flare-ups are generally caused by exercise or fast, sudden motions. These factors place added stress on the spine, which may worsen nerve compression from spondylolisthesis.
Certain forms of exercise are more likely to cause spondylolisthesis flare-ups than others. These include:
Any form of exercise that involves twisting or bending the lumbar spine should be averted with spondylolisthesis. Examples include trampolining, sledding, golfing, gymnastics, and diving. These activities can exacerbate spondylolisthesis symptoms.
Physicians also advise against high-impact exercises for spondylolisthesis patients. Running, jumping, tennis, skiing, football, basketball, and weightlifting are all examples of high-impact activities that may cause spondylolisthesis flare-ups. These activities place a high amount of stress on the joints throughout your body, as well as the spinal structures.
With spondylolisthesis, bending the spine forward with your knees straight can trigger a flare-up. To safely bend forward, you’ll need to bend your knees and engage your abdominal muscles to limit the stress on the spine. Additionally, you’ll need to avoid bending forward while twisting the spine.
No two cases of spondylolisthesis are exactly alike. So, certain movements and activities may be painful for you, in particular. Take note of any motions that worsen your symptoms so that you can avoid them in the future.
The speed at which spondylolisthesis progresses can vary from patient to patient.
In one study, 145 patients with degenerative spondylolisthesis managed without surgery were evaluated over several years. Progression was found in 34% of patients, with the average slip progression occurring over a 10- to 18-year period.
In another study, 31.8% of the study participants experienced slip progression after a minimum of five years of non-operative management. The study concluded that most low-grade cases of spondylolisthesis don’t progress over five years with non-surgical management.
The progression of spondylolisthesis can change depending on various factors, such as the patient’s activity level, diet, whether or not they smoke, etc.
One strategy to prevent spondylolisthesis progression is to optimize specific lifestyle factors that influence the health of your spine, including:
In certain cases, your physician may advise that you rest for a limited period to ease a spondylolisthesis flare-up. However, low-impact exercise that doesn’t involve twisting or bending the spine is beneficial for most patients with spondylolisthesis.
Exercise promotes blood flow, improves flexibility, and strengthens the abdominal and back muscles, which support the spine. Additionally, exercising stimulates the release of endorphins, which are “feel-good” hormones that offer natural pain-relieving and mood-boosting properties. Combined, these benefits of exercise can prevent spondylolisthesis progression.
Eating a healthy, nutrient-dense diet with plenty of fruits and vegetables will give your body the fuel required to recover from spondylolisthesis. Additionally, drink plenty of water and limit your intake of alcohol, which can inhibit your body’s natural healing process.
Smoking is a detriment to the health of your entire body, including your spine. Nicotine is a vasoconstrictor, meaning that it limits blood flow throughout your body. Given that patients with spinal conditions (and virtually any injury) need the oxygen and nutrients that blood carries to the damaged tissues, smoking can severely slow down your spondylolisthesis recovery.
Additionally, managing spondylolisthesis will help prevent the condition from progressing. Physical therapy, bracing, and pain medications are all commonly used to treat spondylolisthesis and stop it from getting worse.
As mentioned above, lifestyle adjustments, bracing, pain medications, and physical therapy can all help ease spondylolisthesis pain. For some patients, epidural steroid injections are also helpful, although you shouldn’t undergo more than three to four shots per year.
Physical therapy for spondylolisthesis generally involves both passive and active treatments. Passive treatments are intended to relax the body and may involve massage, electrical stimulation, hot/cold therapy, and/or ultrasound therapy.
Active treatments involve exercises to stabilize the spine by strengthening various muscle groups and improving the range of motion. Additionally, your physical therapist may work with you to improve your posture and develop healthier habits to support your spondylolisthesis recovery.
For most spondylolisthesis patients, bracing, physical therapy, and lifestyle modifications are sufficient to stabilize the spine. However, when these methods fail to provide improvement, surgery may be considered.
Surgery for spondylolisthesis typically involves spinal decompression and spinal fusion. Spinal decompression alleviates nerve compression by removing certain spinal structures, such as the lamina. Spinal fusion addressed spinal instability by fusing two or more affected vertebrae with bone graft material.
Unfortunately, while spinal fusion stabilizes the spine in spondylolisthesis patients, it also eliminates their mobility at the fused segment. This can restrict their activities while creating the risk of degeneration in adjacent segments.
Non-fusion implants like the TOPS System from Premia Spine offer an alternative to fusion for spondylolisthesis patients. This mechanical device works by creating a controlled range of motion at the affected spinal segment. It offers shorter recovery periods and superior outcomes when compared to spinal fusion.
Patients struggling with symptoms of spondylolisthesis should speak to their physicians about all available treatment options. With the latest medical technology, you may have more options than you realize!
If you’re struggling with persistent back pain along with numbness, tingling, or weakness, you may have a spinal condition. Spondylolisthesis is one possible condition that can trigger these symptoms and ultimately compromise your quality of life.
In this article, we’ll dive into the topic of spondylolisthesis and explain what patients can expect from a spondylolisthesis diagnosis. While the prospect of managing this condition may seem intimidating, rest assured that there are numerous effective treatment options for spondylolisthesis.
With spondylolisthesis, one of the vertebrae in the spine becomes displaced due to instability. As a result, it moves downward in relation to its proper position, settling on the vertebra beneath it.
This malpositioning can put pressure on the spinal cord, as well as the nerves that emanate from the spinal column. This pressure can lead to pain in the lower back and leg.
Spondylolisthesis of the lumbar region (meaning that it occurs in the lower back) is the most common. Specifically, the L5-S1 level of the spine is most frequently affected by spondylolisthesis, followed by the L4-5 level.
You’ve probably heard the common medical term, “a slipped disc”. While this may seem to indicate the slippage involved in spondylolisthesis, it’s an entirely different condition.
Spondylolisthesis affects the spinal bones, which are known as vertebrae. A slipped disc is an injury involving an intervertebral disc, which is a cushion of shock-absorbing tissue. There’s an intervertebral disc located in between each of the vertebrae in the spine.
Given that spondylolisthesis and a slipped disc affect different parts of the spine and develop differently, it’s crucial to distinguish them. A spinal specialist can give you an accurate diagnosis of back pain.
As another spinal condition that’s commonly confused with spondylolisthesis, you may have heard of spondylolysis. This condition, unlike a slipped disc, is related to spondylolisthesis. However, they’re still different conditions.
Spondylolysis is a stress fracture that runs through the pars interarticularis, a small segment of bone that connects two vertebrae. When the pars interarticularis is fractured, patients may experience back pain that worsens with physical activity. However, not all spondylolysis patients have symptoms.
Approximately one out of 20 people have spondylolysis, making it a relatively common condition. Additionally, spondylolysis can lead to spondylolisthesis. This is because the pars interarticularis fracture can diminish the stability of the spine and potentially lead to slippage.
Spondylolisthesis has several possible causes, the most common of which include:
The most common cause of spondylolisthesis is degenerative changes in the vertebral joints and cartilage due to aging. When spondylolisthesis is caused by age-related spinal changes, it’s known as degenerative spondylolisthesis.
Younger individuals may experience spondylolisthesis caused by a birth defect in the facet of the vertebra. The defect, which is present at birth, can cause the vertebra to slip out of position. This is referred to as dysplastic spondylolisthesis.
Spondylolisthesis can also result from sudden trauma, such as a sports injury or car accident. This is known as traumatic spondylolisthesis and can occur in people of all ages.
In athletes that repetitively strain and overstretch the spine, spondylolisthesis is a relatively common injury. This is especially true in younger athletes, given that their spines haven’t fully developed.
The most frequent symptom of lumbar spondylolisthesis is lower back pain. The pain typically worsens after exercise and abates when you sit or bend forward.
Decreased range of motion and tightness of the hamstring muscles are common spondylolisthesis symptoms.
The nerve compression may also result in pain, numbness, tingling, or weakness in the legs, and in cases of severe compression, loss of bowel or bladder control.
Spinal stenosis isn’t exactly a symptom of spondylolisthesis. However, degenerative spondylolisthesis is a prevalent cause of spinal stenosis, which is an abnormal narrowing of the spinal canal.
A physician specializing in spinal disorders can diagnose spondylolisthesis using radiographs and x-ray imaging, as well as a comprehensive physical exam. You’ll likely stand sideways as the x-rays are taken so your physician can see the vertebra’s slippage clearly.
After your physician has examined the imaging test results, the severity of your spondylolisthesis case will be graded. The grading scale is based on the degree of slippage from the vertebra’s normal position.
Upon making a diagnosis, a physician can recommend appropriate treatments for spondylolisthesis.
As aforementioned, spinal specialists use a grading system to determine the severity of spondylolisthesis cases. Spondylolisthesis grades include:
Several factors can worsen spondylolisthesis, including:
If you’ve been diagnosed with spondylolisthesis, your physician likely recommended lifestyle adjustments to help you avoid the factors listed above.
Any exercises that involve heavy lifting and excessive twisting or bending should be avoided with spondylolisthesis. If you enjoy a specific sport, you should talk to your physician about whether it’s safe to participate in that sport while you’re struggling with spondylolisthesis symptoms.
Sports that tend to exacerbate spondylolisthesis symptoms include:
Treatments for spondylolisthesis include physical therapy, exercises for relieving pressure on the affected spinal nerves, medication, and epidural steroid injections. In many patients, these treatments are sufficient to alleviate the symptoms of spondylolisthesis.
Physical therapists can help patients manage spondylolisthesis in several ways.
For one, your PT can offer valuable insights and education about how your lifestyle is affecting your symptoms. From your exercise regimen to your footwear to your posture, your physical therapist can identify areas for improvement. In making the recommended adjustments, you can likely reduce the pressure on your spine, leading to an improvement in spondylolisthesis symptoms.
Additionally, your PT can implement various non-invasive methods of pain management. Targeted heat and cold therapy can help alleviate inflammation and pain. Electrical stimulation is another popular method among physical therapists to gently reduce the transmission of pain signals to the brain.
Physical therapists can also recommend stretching and strengthening exercises for spondylolisthesis. By stretching to reduce muscle tension, you can gain greater back flexibility. By strengthening various muscle groups, you can gain greater stability in the lumbar spine, hips, and pelvis.
Many spondylolisthesis patients find that chiropractic care is a helpful tool for alleviating their symptoms. Chiropractors specialize in spinal manipulation to treat issues involving the musculoskeletal system.
Key goals of chiropractic care for spondylolisthesis include improving spinal mechanics, restoring spinal function, and improving posture. In achieving these goals, your chiropractor may alleviate compression on the spinal nerves, which often leads to reduced symptoms.
One of the main benefits of chiropractic care for spondylolisthesis is that it’s non-invasive. Chiropractors focus on methods including manual and instrument-assisted manipulation to adjust the spine, making it a safe back pain treatment option.
Physicians often recommend over-the-counter medications to help spondylolisthesis patients manage pain and inflammation. In more advanced cases that don’t improve with over-the-counter options, physicians may instead suggest prescription medications.
There are a few different types of drugs that may help with spondylolisthesis. The main types include:
In simpler terms, analgesics are painkillers. These over-the-counter medications’ primary function is to relieve pain. The most common analgesic is acetaminophen, or Tylenol.
NSAIDs alleviate inflammation along with pain. There are numerous over-the-counter NSAIDs, such as aspirin, Aleve, and Advil (ibuprofen), as well as prescription NSAIDs.
This type of prescription medication can be helpful for patients suffering from spondylolisthesis nerve pain. Neuropathic agents target nerve pain directly and can help with spondylolisthesis symptoms including tingling, numbness, and weakness.
Gabapentin and pregabalin (Lyrica) are two of the most commonly prescribed neuropathic agents for spondylolisthesis.
Some spondylolisthesis patients experience chronic back pain caused by muscle spasms in the back. In these cases, physicians may prescribe a muscle relaxant to stop the spasms. Soma, Flexeril, Baclofen, Tizanidine, and Robaxin are among the most widely prescribed muscle relaxants.
For patients with moderate to severe spondylolisthesis who don’t respond to conservative therapies, physicians may recommend spinal decompression surgery. The idea of undergoing surgery can be daunting, but note that most patients’ symptoms improve with non-surgical treatment.
If you and your physician determine that surgery is the right route of treatment, you’ll likely discuss the spinal decompression procedure.
Spinal decompression involves removing portions of the vertebrae that impinge on the spinal cord and nerve roots. There are several different approaches to spinal decompression, including laminectomy, foraminotomy, discectomy, and corpectomy. For spondylolisthesis, surgeons often opt for laminectomy.
Laminectomy involves removing some or all of the lamina. This is the small section of bone that covers the back of the spinal canal. By removing it, your surgeon can create more space for the spinal nerves and alleviate nerve impingement.
Spinal decompression can have a dramatic effect, relieving pain and other spondylolisthesis symptoms. However, removing portions of the lamina reduces the stability of the spinal column. So, after decompression surgery, spinal stability remains a key concern for spondylolisthesis patients.
This is why surgeons traditionally perform spinal fusion after spinal decompression.
Spinal fusion involves placing bone graft material in between the affected vertebrae. Then, screws and rods are implanted to secure the graft in place and provide additional stability.
In the period following spinal fusion surgery, the bone graft material will spur the permanent joining of the affected vertebrae. This prevents all movement between the fused vertebrae, which can prevent instability in spondylolisthesis patients.
Unfortunately, in stabilizing the vertebrae, spinal fusion eliminates the natural independent motion that gives the spine flexibility. This diminishes patients’ ability to carry out certain movements, namely those that require the bending or twisting of the spine. Fusion has also been shown to promote the deterioration of adjacent vertebrae.
In a seven-year study for patients with degenerative spondylolisthesis and lumbar spinal stenosis, the TOPS™ System maintained clinical improvement and stability. Additionally, in a five-year study of the TOPS™ System for 10 patients with degenerative spondylolisthesis and lumbar spinal stenosis, the clinical outcome scores “improved significantly across all scoring systems”. In this study, there were no failures at five years and no patients required revision surgery.
The TOPS™ device is approved for use in Europe and many other countries. In the United States, the FDA granted Premia Spine approval to begin an IDE investigation of the TOPS™ System.
Patient and surgeon testimonials are highly encouraging for the TOPS™ System as a spondylolisthesis treatment. Many patients note that they’re able to return to their favorite activities after the TOPS™ procedure, as it preserves spinal mobility.
We encourage anyone with persistent back problems to consult a physician who specializes in spinal disorders and learn about the latest available treatment options.