Affecting approximately 5 to 7 percent of the population, spondylolisthesis is a condition that results in a bone of the spine (vertebra) slipping below an adjacent bone and shifting the natural alignment of the spine. There are two types of spondylolisthesis: isthmic and degenerative. Though treatment options are essentially universal regardless of what causes the vertebral slippage, each form of the condition has different contributing factors.
Isthmic Spondylolisthesis
This form of spondylolisthesis is caused by a vertebral fracture affecting a small piece of bone (interarticularis) that connects the spinal (facet) joints. It may also result from a structural or genetic defect. The initial fracture often occurs in childhood but doesn’t become problematic until adulthood. There may be a spike in symptoms during adolescence, primarily in the form of lower back pain.
Degenerative Spondylolisthesis
Linked to age-related changes to the spine and progressive conditions like osteoarthritis, degenerative spondylolisthesis may result in vertebral slippage due to lack of support from affected bones. This condition sometimes leads to a gradual narrowing of the spinal canal (spinal stenosis), which can occur along any part of the backbone, including the middle spine and neck.
Diagnosis and Treatment
Diagnosis usually involves image tests and a description of symptoms. Spine surgery is required about 15 to 20 percent of time, although most patients respond well to medication that includes anti-inflammatory drugs (NSAIDs) and some form of physical therapy. When symptoms such as difficulty walking or lower back pain do appear, it’s usually during midlife.
The main difference between isthmic and degenerative spondylolisthesis is the underlying cause that causes the slipped bone. Even though spondylolisthesis is fairly common, 80 percent of patients with either form of the condition will never have any symptoms and won’t even know they have a weakened vertebra.
If you are concerned you might have a spine condition that requires surgery or another treatment, reach out to The Spine Institute Center for Spinal Restoration. Dr. Bae and his team of expert surgeons specialize in spinal fusion as well as alternatives to spinal fusion surgery. Give our office a call today at 310-828-7757 to schedule an in-person consultation.