A spondylolisthesis happens when one of the spine's vertebrae (bones) slips forward over the vertebra beneath it. Spondylolisthesis occurs most often in the lumbar spine (low back).
Some people never know they have a spondylolisthesis because they have no symptoms. When symptoms exist, they typically include one or more of the following:
- Pain in the low back, thighs and legs
- Weakness in the thighs or legs
- Tight hamstring muscles (back of the thighs)
- Loss of, or difficulty with, bowel or bladder control
Spondylolisthesis can alter your appearance. Some noticeable physical differences are:
- Stomach sticks out
- Torso looks shorter
- Swayback (low back curves too far inward)
- Waddle when walking
Doctors describe the severity of a spondylolisthesis using a grading scale from 1 to 5. Grade 1 indicates that 25% of a vertebra has slipped forwards over the vertebra below. A Grade 2 indicates a 50% slip, all the way up to a Grade 5, which represents a 100% slip.
- If the spondylolisthesis is non-progressive then conservative management is recommended
- 1-2 days of bed rest
- Restriction of activities causing stress to the lumbar spine (e.g. heavy lifting, stooping)
- Physiotherapy including a major focus on core stability exercises and clinical pilates
- Anti-inflammatory and pain reducing medications
- Possibility of a corset or brace.
A physician may prescribe a custom-made corset or brace. These are made by an orthotist, a professional who takes the patient's precise body measurements, which may include making a cast from which the molded orthoses is made.
Surgical intervention is considered when neurologic involvement exists or conservative treatment has failed to provide relief from long-term back pain and other symptoms associated with spondylolisthesis.
Whether the treatment course is conservative or surgical, it is important to closely follow the instructions of your physician and/or physiotherapist.
Avoid heavy lifting, stooping, or certain sports such as football or high impact exercise (i.e. running, aerobics). Any doubts concerning vocational and recreational restrictions should be discussed with your physician and/or physiotherapist. They will be able to suggest safe alternatives to help reduce the risk of further back problems.
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