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Spondylolisthesis..a Fracture Dislocation!It can be painful but not always, it depends upon the severity! Spondylolisthesis (pronounced spon-dee-lo-lies-thesis) is related to spondylolisis and is in fact a progression of it. What is it? Spondylolisthesis is a fracture of both sides of the pars interarticularis, the junction where the vertebral arch joins onto the vertebral body. Because the fracture is on both sides of the vertebra, it is less stable.
This allows the stress to overcome the ligaments normally holding it in place. What then happens is the vertebra actually slips forwards on the vertebra below!
Slippage! The amount of slippage is graded from 1-4 (4 being most severe).
Diagnosis is by x-ray and the degree of slippage can be seen easily. I have seen in the past, patients who have had a very minor spondylolisthesis but with no symptoms at all.
Symptoms vary depending on the degree of slippage and can range from simple back ache to full blown leg pain and numbness down the back of both legs. Management also depends upon the severity and the presenting symptoms. Conservative management usually is effective. Particular emphasis should be placed upon strengthening the core muscles of the back/trunk. This is to stabilize the region and help out those stretched ligaments! |
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The unstable segment can cause numerous problems. It can lead to some stenosis of the spinal canal that compromises the spinal cord. The actual slippage of the vertebra may cause pain by irritating the local nerves. Muscles in the area may be in spasm as they try to stabilize the joint, this can cause pain. 
