Spondylolysis and Spondylolisthesis

Overview

When one vertebra slips forward in relation to the one next to it, it is known as spondylolisthesis. If the fracture gap at the pars widens and the vertebra shifts forward, the condition is referred to as spondylolisthesis. Usually, it's the fifth lumbar vertebra that shifts forward on the part of the pelvic bone called the sacrum.

Causes of Spondylolysis and Spondylolisthesis

If the stress fracture weakens the bone to the point where it can't maintain its proper position, the vertebra will start to shift out of place. If too much slippage occurs, the bones can begin to press on the nerves. At this point, surgery is usually required to correct the condition.

Factors causing these conditions include:

• Genetics - An individual may be born with thin vertebral bone and therefore may be vulnerable to this condition.
• Rapid growth may encourage slippage.
• Overuse - Some sports, such as gymnastics, weight lifting, and football, put a great deal of stress on the bones in the lower back.

Symptoms

Some people remain symptom free and are not aware of the injury until an x-ray is taken of the region.
If pain is felt, it usually spreads across the lower back and can feel a lot like muscle strain. Other symptoms include:

• Pain in the lower back, thighs and/or legs
• Muscle spasms
• Weakness
• Tight hamstring muscles

In advanced cases, the patient can also appear swayback with a protruding abdomen or have a shortened torso or a waddling gait.

Treatment

Once your doctor at the FHCH Sports Medicine Program conducts a basic exam, the next step will be an x-ray of the lower back to show the position of the vertebra. If the vertebra is pressing on nerves, a CT scan or MRI may also be needed to fully assess the situation.

Treatment depends on which of the seven cervical vertebrae are damaged and the kind of fracture that has occurred. A minor compression fracture can be treated without surgery. Instead, a cervical brace will need to be worn for 6 to 8 weeks so the bone can heal properly.

If the fracture is extensive, traction may be required. Other options include an internal fixation, 2 to 3 months in a rigid cast, surgery or a combination of treatments.

For surgical options, click here.

If you have questions about spondylolysis and spondylolisthesis or want to make an appointment, please contact one of our Patient Care Coordinators and they'll be happy to help you.