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Spondylolisthesis

Spondylolisthesis is a condition that affects the bones of the spine known as the vertebra. The condition is manifest in the slippage of one vertebra over the other which causes irritation and compressive forces to surrounding structures resulting in pain. Normally this condition is found in the lumbar spine (lower back). Spondylolisthesis can be classified into two categories, congenital (present at birth) or acquired (as a result of trauma/injury).

Grading of injury

When reviewing spinal x-rays, the radiologist will normally determine the grade of injury based on the movement that has occurred.

Slippage is graded from one to four as follows:

  • Grade I – 1% to 25%
  • Grade II – 26% to 50%
  • Grade III – 51% to 75%
  • Grade IV – 76% to 100%

Most commonly grade I and II slips are treated with conservative management by a physiotherapist. Grade III and grade IV slips may require surgery if the symptoms are persistent and with pain.

Symptoms

Th majority of those who suffer with spondylolisthesis do not have any obvious symptoms. The condition is not normally discovered until imaging of the spine has been completed for unrelated injury or pain complaints.

In cases where symptoms do occur, you may feel:

  • Lower back pain
  • Feeling of muscle strain
  • Radiating pain into the back of the thighs and/or buttocks
  • Worsening with activity and improvement with rest
  • Difficulty standing and walking
  • Back stiffness
  • Tightness in the hamstrings

Causes

Most commonly this condition is found in teens who are going through a growth spurt or more likely in those who participate in sports that require repeated extension movements on the spine. Sports such as cricket, gymnastics and weight lifting all involve repeated extension of the lumbar spine which can cause compression and irritation and can lead to spondylolysis. With this condition it is common when untreated to end up resulting in slippage causing spondylolisthesis.   

Prevention+ Management

Although you may not be able to stop yourself from getting this condition there are some preventative steps you can take in ensuring you are at the low risk of the condition occurring.

  • Ensure your abdominal and back muscles are strong to provide adequate stability
  • Choose activities that will not cause back strain over time
  • Maintain a healthy weight for your height and size
  • Ensure nutrition is good with a healthy balance diet
  • Ensure training loads are not too much for your individual level.

If you feel you are currently experiencing this condition you should get medical advice from a professional as well as:

  • Taking a rest from any activities that may provoke your pain
  • Strengthening exercises as given by your physiotherapist
  • Over the counter medication such as NSAIDs with help to reduce pain and irritation over the area.
  • Bracing will sometimes give short term relief by limiting movement in the spine and provide the opportunity for the fracture to heal.
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