Adult Spondylolisthesis in the Low Back
Spondylolisthesis is a condition of the spine characterized by the forward displacement of a vertebra over an underlying vertebra. Degenerative spondylolisthesis is a type of spondylolisthesis that occurs as a result of degenerative or age related changes to the spine. The condition most commonly affects the lumbar spine (low back).
Degenerative disc disease and spondylosis damage the structures of the spine, including the bones, joints, and the ligaments. A back injury, excess body weight, poor posture, or repetitive motions can aggravate degenerative spondylolisthesis.
The main symptoms of degenerative spondylolisthesis include low back pain or neck pain, sciatic pain, weakness in the legs, tightness of the hamstrings (leg muscles), muscle spasms, abnormal gait, and rarely loss of bowel or bladder control.
An accurate diagnosis of degenerative spondylolisthesis and an effective treatment plan are important for a successful treatment outcome. Your doctor will diagnose the condition based on your symptoms, medical history, family history and physical examination. A neurological examination is also required to test your reflexes, muscle strength, and sensations. Your doctor may also recommend diagnostic tests such as an x-ray, computed tomography (CT) scan or magnetic resonance imaging (MRI). X-ray of the spine may help to assess the position of the vertebrae. A MRI scan may be needed to identify the nerve or spinal canal compression.
Grades of spondylolisthesis
The Meyerding Grading System is the most common grading system used to classify the degree of vertebral slippage. Your doctor would grade your Spondylolisthesis with the help of spinal X-rays.
- Grade I indicates 1 % to 24 % slip of the vertebral body
- Grade II indicates 25% to 49 % slip
- Grade III indicates 50 % to 74 %
- Grade IV indicates 75 % to 99 %
- Grade V is a complete slip (100%), known as spondyloptosis
Most cases of degenerative spondylolisthesis are managed with non-surgical treatments without the need for a surgery. The non-surgical treatment options include a short period of rest, activity modification, anti-inflammatory and pain medications, muscle relaxants, spinal injections, bracing, physical therapy, and acupuncture. Your doctor may recommend a combination of one or two treatment options to increase the success of your treatment.
In a majority of the patients, degenerative spondylolisthesis can be managed with conservative treatment. Surgery may be considered in the following conditions:
- The vertebra continues to slip
- Neurologic problems
- Pain not relieved by non-surgical treatment
The aim of the surgery is alleviate the pressure over the nerve and provide stability to the spine. Spinal stabilization and fusion are common procedures performed to halt progression of the disease and stabilize the spine, during the healing process. A minimally invasive spine surgery may be required for patients with neurological problems.
Degenerative spondylolisthesis can progress and worsen over time; hence, regular follow up with your doctor is important to monitor your condition and treatment outcome. Most people fully recover and return to a healthy, pain free, active lifestyle. Your doctor is a reliable source to answer your queries regarding degenerative spondylolisthesis.
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Houston Back and Spine Specialists
Advanced Orthopedics and sports medicine has Board Certified/Eligible physicians who are thoroughly educated in the latest treatment techniques both surgical and conservative. The spine surgeons practice conservatively utilizing minimally invasive techniques whenever possible. Should surgery be required, options range from out-patient spinal surgery to major spinal reconstruction and management of scoliosis.
Contact us today to Schedule an Appointment or call us at 281-955-2650 to learn more about our Back and Spine Treatment options.
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What Our Patients Are Saying
I had been in so much pain with my back for years. It got so bad that I knew I had to do something. I went to Dr Mohr for help. I was so afraid to have spine surgery as I had heard so many horror stories. He and his staff were very informative. I was amazed at the new technology in spinal surgery. December 8, 2016 I had rods and pins put in my back. I am so happy I did now. I am healing really fast and the pain is going away as my body heals. Thank you Dr Mohr for you expertise and sensitive nature. You were understanding about my fear and helped assure me so I could receive the help I needed. You are an excellent Doctor.
I have been a patient of Dr. Cubbage for several years. Each time of go there, he always presents a thorough plan of care. From ordering the most appropriate diagnostic tests to making sure you understand each step of his plan of care. He consistently instills confidence that you are the road to recovery.
Plus his assistant Karen is extremely knowledgeable and very caring!
I would highly recommend Dr. Cubbage if you are having any type of spinal issues. I have seen Dr. Cubbage several times over the last 3 years for lumbar pain and numbness in my left leg. Dr. Cubbage explained my diagnostic results in such a way that it was easy for me to understand. He patiently answered all my questions and explained my options. Fortunately, Dr. Cubbage has been able to manage my pain with conservative treatment but know surgery is inevitable. When that time comes, I would choose no other than Dr. Cubbage! And it’s a plus that he has such a kind and caring staff.
For the first time in many years and many knee operations on one leg I am without any knee pain. This is a result of a procedure performed by Dr. Patel.
I made an appointment to see Dr. Patel on the recommendation of Dr. Tanous following knee replacement and several months of continued pain. Dr. Patel explained the procedure to me and explained how we would proceed. The first procedure was to determine if I would be a good candidate for the second procedure. After the first procedure my pain was anywhere from 0 and 5. Dr. Patel explained to me at follow-up that I was not a good candidate for the second procedure due to my pain level being above the 0 to 3 level. After talking for a while I said “any relief would be better than the pain I had been having.” With this it was agreed that I would have the second procedure. It has now been 6 days since the procedure and I am without any pain.
I realize this is only a few days of not being able to sleep, with a pillow between my knee or under my leg at night. I know the pain may come back at anytime but until then it has been well worthwhile. I hope it will last 6 months, if not, I will have the procedure again after 6 months.
Thank you Drs. Patel and Tanous.
Outstanding Physicians. I’ve had two surgeries here, one on my foot with Dr. Bacon, and an extensive back surgery with Dr. Cubbage. I’m new to the area and my wife found me these surgeons. I have to say that each surgery I’ve had with these physicians have had excellent results. I was very pleased with my foot surgery and decided to see Dr. Cubbage for my back. Other surgeons I’ve seen regarding my back only gave me a 50/50 success rate. I have to say, the low back surgery with Dr. Cubbage was like a miracle. Right away, I noticed a difference and I’ve continued to improve rapidly. I’m almost eight weeks out and I haven’t felt this good in years. I’d like to thank Dr. Stacy Bacon for my foot surgery and Dr. Matthew Cubbage for my low back surgery. Without these drastic results, I’d not be walking today. Thank you all very much and I highly recommend your services. God bless you all.
Dr. David R. Mack replaced my right hip in June 2009, and my left in October 2010. I am already able to go places and do things on my own again. His excellent staff are very caring and helpful throughout the entire process, including recovery. The out-patient therapy is the best. I am walking very well now and am very pleased to have my life back. Thank you so much Dr. Mack and your great staff! Sincerely,
Dr. Bacon, I can never thank you enough for what you have done for me and for my daughter, Melia. In 2011, on the first anniversary of my surgery, my wife and I walked for two hours on Copacabana beach in Rio. I also completed a four hour nature walk over rough terrain in The Falklands and hiked to del Fin del Terre at the tip of South America. You are truly a great doctor, and I thank God every day for you and for Dr. Fogarty who recommended you for Melia’s surgery.
When I started, I couldn’t put any weight on my right leg and now I can do virtually anything. While I hope to not need future therapy, this is without a doubt the place I will return to in the future.
It has been eight weeks since my partial knee replacement and now I realized just how much I was missing. Having it done has made such a difference to my life. For a start my leg is now straight and my knees actually touch! I have started walking and even plan to ride my bike. The most thrilling part is that I am playing and dancing with my grandchildren again.