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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Overall excellent experience with Dr Cubbage and his outstanding staff. I flew in overseas for a 2nd opinion and was accommodated by his office. My situation was not good and had lower lumbar surgery (METRx discectomy) for a herniated disc. I walked out after surgery and I am on my way to a quick recovery. I have a very small incision and was very well looked after. Thank you Dr Cubbage! Arrived in Houston in a wheelchair and will fly back overseas 10 days after surgery on my own 2 feet
Awesome! Highly recommend Dr.Matthew Cubbage . He is the best of the best Orthopedic Surgeon with special healing hands any patient will experience. He is highly knowledgeable, caring and confident since everything that he explained to me that would happen and what to expect is very accurate. Dr. Matthew Cubbage care and people skills are clearly seen and felt also by his team he selected-Tim and Karen. Courteous and promptly responds on you calls before and throughout your recovery. Reborn.
Each procedure done by Dr. Patel has been an improvement. Very pleased.
Dr. Patel has been a great Doctor for me. When I was referred to after discussion we decided to do injections in my back. The first two did not work so did two more in a different section of my back. These injections worked great. I’m now able to sleep at night and the numbness in my foot is almost gone. The tingling in my foot & leg is gone and I am very happy about that. I am extremely happy that Dr. Patel is my Doctor. She has been a good listener when I tell her where I hurt and talks to me about what she feels should be done. The final decision is always mine.
On Nov. 22, 2017, I had a spinal injection in my lower back and it was an instant miracle in my life! For the first time in 4 intolerable months of pain, I was finally pain free, and I am now getting a second chance to live again! I am so grateful to Dr. Patel for my new life, and to God for guiding me to her! Thank you so very much Dr. Patel – you are God’s gift to me, thank you for being so awesome at what you do.
Dr. Patel is one of the best Doctors I have ever had. She is pretty good at her job. She makes it plain and simple. She is also very thoughtful. I was very glad to have met her. In other words she is pretty good.
The surgery done by Dr. S. Patel (Actually injections) & the mild medications she has prescribed has surely made my lower back -hip-leg less painful. I have complete confidence in her medical judgement & advice. She will administer second injection in June.
Dr. Patel is a very good Pain Management Doctor. She is one of my favorite doctors.
Dr. Patel has been great at my pain relief. She doesn’t force me to take any meds I don’t want, or injections. She will give me the injection I want when I need it. Great friendly Doctor.
Thank you for the opportunity to express how pleased I am with the excellent care of Stacy A. Bacon, M.D. I have confidence in her ability to care for me as she successfully partially replaced a broken hip 10 years ago, 2007. I also want to compliment Cheryl who set up the appointment. She represents Advanced Orthopaedics & Sports Medicine very well.