Spondylolisthesis

Spondylolisthesis Symptoms

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. 

Table of Contents

• What Are the Signs and Symptoms of Spondylolisthesis?
• What Is the Most Common Cause of Spondylolisthesis?
• What Is the Best Test for Spondylolisthesis?
• What Is the Best Treatment for Spondylolisthesis?

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.

L4-L5 Spondylolisthesis

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. 

Table of Contents

• What is Spondylolisthesis at L4 L5?
• What Are The Symptoms of L4-L5 Nerve Damage?
• Can L4 and L5 Spondylolisthesis Cause Hip Pain?
• Can You Be Paralyzed From Spondylolisthesis?
• Can I Go To The Gym With Spondylolisthesis?
• What Are The Treatment Options for L4-L5 Spondylolisthesis?

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. 

Spondylolisthesis Surgery Recovery

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. 

Table of Contents

• What Grade of Spondylolisthesis Needs Surgery?
• Spondylolisthesis Surgery: An Overview
• How Long Does Spondylolisthesis Surgery Take?
• Can I Avoid Spinal Fusion For Spondylolisthesis?
• What Are Pre-Spondylolisthesis Surgery Preparation Steps?
• Steps to Recover Faster From Spondylolisthesis Surgery
• Does Spondylolisthesis Go Away After Surgery?

What Grade of Spondylolisthesis Needs Surgery?

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:

• Grade 1: 1% to 25% slippage
• Grade 2: Up to 50% slippage
• Grade 3: Between 50% and 75% slippage
• Grade 4: Greater than 75% slippage

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: An Overview

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. 

How Long Does Spondylolisthesis Surgery Take?

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. 

Can I Avoid Spinal Fusion For Spondylolisthesis?

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. 

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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. 

What Are Pre-Spondylolisthesis Surgery Preparation Steps?

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:

• Talk to your physician about all of the medications that you’re currently taking, including supplements. You may need to stop taking some or all of these medications leading up to the surgery. 
• Check how long before the surgery you’ll need to stop eating and drinking. Generally, patients must stop eating six hours before surgery and stop drinking fluids two hours before surgery. 
• Reach out to loved ones to ask for assistance in the first few days after the surgery. Additionally, you’ll need to have someone pick you up from the hospital and drive you home after the procedure. 
• Consider stocking up on prepared food before the procedure. Patients generally can’t spend prolonged periods cooking after the surgery, so prepared meals can simplify your recovery process. 
• Invest in tools that can facilitate your healing process, such as slip-on shoes, a reacher or grabber tool, and a toilet riser. These tools can help you avoid straining your spine as you recover from the surgery. 
• Place essentials, such as dishes, toiletries, and clothes, on easy-to-reach surfaces. 

Steps to Recover Faster From Spondylolisthesis Surgery

With a few simple tips, you can recover faster from spondylolisthesis surgery. 

1. Quit smoking. Nicotine is a vasoconstrictor, meaning that it causes blood vessel constriction. Smoking during your recovery process will decrease the flow of oxygen and healing nutrients throughout your body. 
2. Get moving. While you need to follow your spine surgeon’s safety guidelines, gentle movement is beneficial for healing after spondylolisthesis surgery. Work with a physical therapist to learn targeted exercises that will improve muscle strength and mobility. 
3. Hydrate and eat a healthy diet. Fueling your body properly will support your body’s recovery process. 
4. Set up your home for success. As we mentioned in the previous section, prepping your home to limit bending and reaching motions will support the early stage of spine surgery recovery. 
5. Follow all of your surgeon’s wound care instructions to prevent infection. 

Does Spondylolisthesis Go Away After 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. 

Can Spondylolisthesis Be Reversed?

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.

Table of Contents

• Is Spondylolisthesis a Permanent Condition?
• How Long Does it Take to Heal Spondylolisthesis?
• What Can Make Spondylolisthesis Worse?
• How to Treat Spondylolisthesis Naturally?
• The Best Treatment For Severe Spondylolisthesis

In this article, we’ll discuss how long spondylolisthesis typically lasts and whether or not it can be cured.

Is Spondylolisthesis a Permanent Condition?

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. 

How Long Does it Take to Heal Spondylolisthesis?

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. 

What Can Make Spondylolisthesis Worse?

Several lifestyle factors can worsen spondylolisthesis and inhibit your recovery process. These factors include:

• Poor posture

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

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. 

• Being overweight

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.  

• Participating in high-impact activities

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. 

How to Treat Spondylolisthesis Naturally

Most cases of spondylolisthesis can be treated naturally, without the need for surgery. In these cases, spine specialists may implement spondylolisthesis treatment options including:

Bracing

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

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. 

Low-Impact Physical Activity

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. 

Pain Medications

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. 

The Best Treatment For Severe Spondylolisthesis

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

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. 

• Spinal fusion

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:

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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. 

Non-Fusion Surgery For Degenerative Spondylolisthesis of The Lumbar Spine

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. 

Table of Contents

• When is The Time to Have Surgery For Spondylolisthesis?
• Am I a Candidate For Spondylolisthesis Surgery?
• Is Spinal Fusion Always Necessary For Spondylolisthesis?
• An Overview of Spinal Fusion
• What is a Non-Fusion Spinal Surgery?

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. 

When is The Time to Have Surgery For Spondylolisthesis?

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:

• Physical therapy, which generally focuses on targeted exercises and passive therapies to increase mobility and muscle strength
• Chiropractic care, which focuses on restoring the alignment of the spine
• Medications for pain and inflammation, which may be obtained either with a prescription or over-the-counter
• Epidural steroid injections, which can rapidly alleviate pain and inflammation, but shouldn’t be used for than three to four times per year
• Lifestyle modifications, which may involve a targeted exercise plan, avoiding specific activities, quitting smoking, etc.

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. 

Am I a Candidate For Spondylolisthesis Surgery?

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. 

Is Spinal Fusion Always Necessary For Spondylolisthesis?

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:

• Grade 1 spondylolisthesis: 25% of the vertebra has shifted forward 
• Grade 2 spondylolisthesis: 50% of the vertebra has shifted forward
• Grade 3 spondylolisthesis: 75% of the vertebra has shifted forward
• Grade 4 spondylolisthesis: 100% of the vertebra has shifted forward
• Grade 5 spondylolisthesis: The vertebra has fully fallen off of the next vertebra (also known as spondyloptosis

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. 

An Overview of Spinal Fusion

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. 

What is a Non-Fusion Spinal Surgery?

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. 

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Non-fusion implants and artificial disc replacement surgery can provide the following benefits over conventional fusion:

• Preserve the motion of the spine so that patients can return to their usual activities while experiencing relief from back pain and neurological symptoms
• Reduce the risk of degeneration in the adjacent spinal segments, which is a relatively common complication of spinal fusion
• Lower the risk of revision surgery
• Shorten the spinal surgery recovery process

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. 

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

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

Table of Contents

• What Are The Symptoms of Spondylolisthesis?
• How Did I Get Spondylolisthesis?
• How Do You Stabilize Spondylolisthesis?
• Does Spondylolisthesis Ever Heal?
• Can Spondylolisthesis Be Reversed Without Surgery?
• What Is The Best Treatment For Spondylolisthesis?
• Fusion Isn’t The Only Option!

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

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

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

What Are The Symptoms of Spondylolisthesis?

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

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

How Did I Get Spondylolisthesis?

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

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

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

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

How Do You Stabilize Spondylolisthesis?

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

Some of the best exercises for spondylolisthesis include:

• Knee To Chest

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

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

• Pelvic Tilt

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

Repeat 5 to 10 times. 

• Bird-Dog Exercise

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

Spondylolisthesis Exercises To Avoid

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

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

Does Spondylolisthesis Ever Heal?

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

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

Can Spondylolisthesis Be Reversed Without Surgery?

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

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

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

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

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

What Is The Best Treatment For Spondylolisthesis?

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

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

• Laminectomy

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

• Spinal fusion

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

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

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

Fusion Isn’t The Only Option!

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

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

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

What Makes Spondylolisthesis Worse?

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. 

Table of Contents

• Why is Spondylolisthesis So Painful?
• What Causes Spondylolisthesis Flare-Ups?
• How Fast Does Spondylolisthesis Progress?
• How Do You Stop Spondylolisthesis From Progressing?
• What Helps Ease Spondylolisthesis Pain?
• How Do You Stabilize Spondylolisthesis?

Why is Spondylolisthesis So Painful?

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. 

What Causes Spondylolisthesis Flare-Ups?

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:

• Exercises that require bending and/or twisting the lumbar spine

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. 

• High-impact exercise

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. 

• Exercises that involve bending forward with straight knees

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. 

• Any other activity that causes pain and/or neurological symptoms

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.   

How Fast Does Spondylolisthesis Progress?

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. 

How Do You Stop Spondylolisthesis From Progressing?

One strategy to prevent spondylolisthesis progression is to optimize specific lifestyle factors that influence the health of your spine, including: 

• Exercise

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. 

• Nutrition

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

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. 

What Helps Ease Spondylolisthesis Pain?

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.   

How Do You Stabilize Spondylolisthesis?

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. 

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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! 

Physical Therapy After Spondylolisthesis Lumbar Surgery

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. 

What is Lumbar Spondylolisthesis?

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:

• Lower back pain
• Tenderness in the lower back
• Lost range of motion in the back and legs 
• Tightness in the buttock and thigh muscles
• Pain in the thighs

Causes of Lumbar Spondylolisthesis

Most often, lumbar spondylolisthesis is caused by overstretching the spine. Genetics, age, and certain lifestyle factors can increase your risk of developing the condition.

Age

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. 

Athletics

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. 

Non-Surgical Treatment For 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:

• Taking a break from intensive physical activity

Especially for athletes and people with physically demanding jobs, rest can ease pain and inflammation from spondylolisthesis. 

• Physical therapy

Physical therapy for spondylolisthesis can reduce stress on the spine and ease the pain with targeted exercises and pain management methods. 

• Medications

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.  

An Overview of Surgery for Lumbar Spondylolisthesis

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. 

Spinal Decompression Surgery

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

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. 

Spinal Fusion Alternatives

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. 

What Does Physical Therapy After Spondylolisthesis Surgery Involve?

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:

Pain-Relieving Treatments

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.  

Targeted Exercises and Training

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:

• Weight training
• Balance exercises
• Re-learning body mechanics (pulling and pushing, carrying, etc.)
• Abdominal exercises
• Cardiovascular/endurance conditioning
• Stretching

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. 

Exercise Regimen

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.

Aquatic Therapy

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. 

Making a Full Recovery With Physical Therapy 

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. 

The Premia Spine TOPS System is an alternative to spinal fusion that can shorten your recovery period after spondylolisthesis surgery. To learn more, contact Premia Spine today.  

How to Adjust Your Lifestyle for Faster Recovery from Spondylolisthesis Treatment Surgery

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:

• Lower back pain can worsen while standing or being active.
• Consistent pain, a numb feeling, or a tingling sensation that can spread from the spine to the top of the legs.
• Spinal curvature. 
• Stiffening or tightening of the back.
• Tightening of the hamstring muscles.

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; 

• Repetitive trauma results in a defect that eventually causes the bone to slip, this is most common for people who play a lot of sports or are very active in the gym. 
• A birth defect in the spine.
• An abnormality such as a tumor. 
• Amongst older people, the condition could simply be a result of age, with the bones becoming worn over time, or maybe a result of arthritis.
• A significant impact, or trauma to the spine. E.G a fracture. 

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. 

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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:

1. Hydration – It sounds very simple but drinking plenty of water and reducing the consumption of things like coffee and alcohol can be very helpful as it results in the tissue producing less lactic acid.
2. Quit smoking – Smoking has been proven to weaken bones and speed up the degeneration of things like the spinal disc. This could prevent the bones from fusing correctly.
3. Sleep – Make sure you get a good night’s sleep to allow your body to repair itself. 
4. Keep your weight down – Focus on maintaining a healthy diet, combined with moderate exercise to keep your weight down and limit any additional pressure on your spine. 
5. Try to move frequently – It may be tempting to avoid regular movement but it is vital to speed up the healing process and reduce the risk of complications.
6. Posture – When sitting, focus on your posture and avoid slouching or hunching over your desk to ensure your spine is correctly aligned.

We hope this article has been of use and answered any questions you may have. 

Spondylolisthesis Grades and Physical Therapy

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.

Spondylolisthesis Grades

The Meyerding Classification divides levels of spondylolisthesis into five grades. The location of the posteroinferior corner of the vertebra above influences the grade.

• Grade One: 0-25%
• Grade Two: 26-50% 
• Grade Three: 51-75% 
• Grade Four: 76-100%
• Grade Five, when spondylosis can be identified: >100%

Symptoms 

Spondylolisthesis can cause various symptoms that can help to diagnose this disorder. Some of them include: 

• Intermittent pain localized in the lower back area. People who suffer from cervical spondylolisthesis can feel pain in the neck.
• The pain can increase when an affected segment is flexed or extended. Mechanic pain caused by motion can appear. 
• The pain can increase while touching the affected area. 
• The pain can radiate to other parts of the body, for example, the legs, because the nerve roots can be under pressure.
• The pain can be eased while lying down, as in this position the pressure on the bony elements is reduced.
• Pain in the lower back. 
• Muscle weakness and atrophy. 
• Tense hamstrings. Spasm in legs. 
• Difficulty in walking, problems with coordination and balance. 
• Rare appearances of loss of bowel and bladder control.

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.

Ultrasound 

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. 

Active Treatments 

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:

• balance training: sensomotoric exercises on unstable ground, coordinative skills, walking,
• hydrotherapy, 
• Gailt training,
• anitlordotic movement patterns of the spine, 
• Elastic band exercises

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.

Surgery

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.