Spondylolisthesis (Spinal Slippage)

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Spondylolisthesis (Spinal Slippage)

Spondylolisthesis, or spinal displacement (spinal slippage), is the displacement of one or more vertebrae in the spine that are normally aligned, due to various reasons. This displacement can occur forwards, backwards, to the right, or to the left, affecting the neck, back, or lower back. It can occur in a single vertebra or multiple vertebrae, most commonly affecting the lower back. Cases in the neck and back regions are typically trauma-related.

Spondylolisthesis is classified into six main categories based on its causes:

  • Degenerative: Typically seen in middle-aged and older individuals, it results from the aging-related degeneration of small joints in the spine and the weakening of ligaments between vertebrae.
  • Traumatic: It occurs due to fractures in the back of the spine resulting from an accident.
  • Dysplastic: It arises from congenital abnormalities in the spine bones.
  • Isthmic: It results from defects in the spine bone's back part (pars interarticularis) due to various causes.
  • Pathological: It results from conditions such as infection or tumor.
  • Post-surgical: It occurs as a result of previous spinal surgeries.

Spondylolisthesis is categorized into four grades based on its severity:

  1. Grade 1: 0-25% displacement.
  2. Grade 2: 25-50% displacement.
  3. Grade 3: 50-75% displacement.
  4. Grade 4: 75-100% displacement.

Symptoms of spondylolisthesis vary based on the location of displacement. Common symptoms include stiffness in the lower back, a feeling of tension in the legs, pain in the lower back, buttocks, and legs, and numbness. Diagnosis involves physical examination and tests such as nerve stretching tests, sensory defects, and muscle weakness, along with imaging tests like X-rays, CT scans, MRI scans, and electrophysiological tests.

Treatment options include conservative (non-surgical) and surgical approaches:

  • Conservative treatment includes pain medications, exercises, wearing a brace, and physical therapy, and is typically used for mild cases with intermittent pain and normal examination results.
  • Surgical treatment is reserved for severe cases with constant and severe pain, along with sensory and muscle weakness. It involves relieving compressed nerves and stabilizing the spine by correcting the displacement and using screws to fix the vertebrae together.

Wishing you good health.

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