What Are My Options For Spondylolisthesis Treatment?

Several spinal conditions may trigger chronic back pain, and spondylolisthesis is one of them. Stemming from spinal instability, spondylolisthesis compromises the alignment and strength of the spine,  

There are numerous treatment options available for spondylolisthesis, including both non-invasive and invasive approaches. In fact, with recent advancements in clinical technology, spondylolisthesis patients have more options than ever before. 

Spondylolisthesis: Causes and Symptoms

Causes

Spondylolisthesis may be caused by many different factors. The types of spondylolisthesis are categorized according to these factors and include:

Degenerative spondylolisthesis

Degenerative spondylolisthesis occurs in older patients as a result of age-related changes to the spine. As people age, the bones, ligaments, and joints of the spine weaken. This can compromise the structural integrity and alignment of the spine, potentially leading to spondylolisthesis. 

This form of spondylolisthesis is generally found in patients over the age of 50. However, it’s particularly common in patients over the age of 65. Additionally, degenerative spondylolisthesis most often develops in the lumbar spine. 

Isthmic spondylolisthesis

Isthmic spondylolisthesis is the most common form of spondylolisthesis. Prevalent among athletes who frequently overextend the spine, this form of spondylolisthesis stems from a small fracture in the pars interarticularis, or isthmus, which is the piece of bone that links one facet joint to the next. This type of fracture occurs as the result of repeated stress to the spine. 

Most often, isthmic spondylolisthesis develops at the lumbar spine’s lowest level. Unlike degenerative spondylolisthesis, this type of spondylolisthesis is found in patients ranging from adolescence to older age. 

Traumatic spondylolisthesis

Traumatic spondylolisthesis develops as the result of a traumatic injury. With this type of spondylolisthesis, a direct trauma to the spine causes a fracture and vertebral slippage. However, traumatic spondylolisthesis is considered rare, with far fewer cases than either degenerative or isthmic spondylolisthesis. 

Pathologic spondylolisthesis

Pathologic spondylolisthesis is caused by a disease or disorder affecting the spine. These disorders may include tumors, osteoporosis, forms of cancer, or Paget’s disease of the spine, to name a few. These disorders may weaken the spine or affect its structure and alignment, potentially leading to vertebral slippage. 

Dysplastic spondylolisthesis

Dysplastic spondylolisthesis is present from birth. As a congenital condition, it’s caused by the abnormal development of part of the vertebrae, which leads to spondylolisthesis. 

Symptoms

The symptoms of spondylolisthesis can vary from patient to patient, mainly depending on the severity of the case. Symptoms may include:

• Back pain
• Back stiffness
• Tightness in the hamstring muscles
• Neurological symptoms in the extremities, such as weakness, numbness, and tingling
• Sciatica 
• Altered bladder or bowel function (in advanced cases)

Can I Reverse Spondylolisthesis?

To reverse the misalignment of the spine caused by spondylolisthesis, surgery is required. Non-surgical methods aren’t sufficient to return the slipped vertebra back to its original position. 

However, mild cases of spondylolisthesis (especially in younger individuals) can often fully heal without surgery. After three to six months of conservative treatment, many patients with mild spondylolisthesis achieve complete relief from their symptoms. 

Unfortunately, if spondylolisthesis occurs as the result of age-related degenerative changes in an older patient, the body likely won’t heal as quickly. 

Non-Surgical Treatment For Spondylolisthesis

Patients with spondylolisthesis will typically start with a non-surgical treatment plan. Non-surgical therapies can be combined into a single treatment plan to help relieve pain, improve spinal alignment, and restore spinal function. 

Non-surgical treatment options for spondylolisthesis include:

Physical Therapy

Physical therapy stretches and exercises for spondylolisthesis promote stability and spinal alignment while relieving muscle tension. A physical therapist can also offer advice on how to manage and improve spondylolisthesis pain with adjustments to your daily habits. 

Pain Medication

Pain medication like NSAIDs (non-steroidal anti-inflammatory drugs) can help patients manage pain and inflammation from spondylolisthesis. Patients with mild to moderate cases of spondylolisthesis can often manage their pain with over-the-counter medications. But, for patients with severe spondylolisthesis pain, physicians may prescribe stronger medications. 

Steroid Injections

An epidural steroid injection can provide immediate pain relief by delivering anti-inflammatory medication straight to the spine. However, steroid injections can weaken the spinal structures, so they should only be used a few times per year. Doctors will typically only recommend steroid injections for pain relief after other conservative therapies have failed. 

Lifestyle Modifications

Physicians also recommend lifestyle modifications to support the spondylolisthesis recovery process. These lifestyle changes may include:

• Resting and avoiding repetitive motions that place stress on the spine
• Quitting smoking, which compromises your overall wellness
• Regularly partaking in low-impact exercise to retain spinal mobility and enhance circulation
• Staying at a healthy body weight 
• Maintaining proper posture to limit stress on the spine from misalignment
• Getting a full night of sleep every night to support the body’s natural healing process

Surgical Treatment For Spondylolisthesis

Spinal fusion is the surgical method most commonly implemented for spondylolisthesis. With the goal of stabilizing and preventing motion in the injured part of the spine, fusion involves merging two vertebrae into a single bone. 

In spinal fusion, the surgeon first accesses the spine through an incision. If needed, the surgeon will remove some spinal tissue to alleviate nerve compression. Then, the surgeon will place bone graft material in between the vertebrae to be fused, securing it with the help of implants like cages, plates, and rods. 

Unfortunately, since spinal fusion eliminates motion at the fused vertebrae, it significantly decreases the patient’s flexibility in the back. This can limit the patient’s activities and may hold them back from partaking in sports that they used to love. 

Non-Fusion Spinal Implants That Can Be Used in Spondylolisthesis Surgery

Spinal fusion alternatives like a non-fusion spondylolisthesis surgery implant can preserve patients’ back mobility while resolving pain and instability from spondylolisthesis. Implants like the Premia Spine TOPS System stabilize and support the spine while reducing the spondylolisthesis surgery recovery time. 

Spondylolisthesis patients should discuss the broad range of treatment options available to them with a spinal specialist.