S P ONDY LOL IS THE S IS

BSN-III
SPONDYLOLISTHESIS
• Spondylolisthesis is where one of the bones in your spine, known as a vertebra, slips out of position,
it may move forward (anterolisthesis) or backward (retrolisthesis).
• It's most common in the lower back, but it can also happen in the mid to upper back or at the top of
the spine at the back of your neck.
• This usually occurs because there is a spondylolysis in the vertebra on top. 
Spondylosis refers to a defect in one of the vertebra in the lower back, usually the last vertebra of
the lumbar spine.
Grades of Spondylolisthesis:
Grade I is a slip of up to 25%.
Grade II is between 26%-50%.
Grade III is between 51%-75%.
Grade IV is between 76%-100%.
Grade V, or spondyloptosis, occurs when the vertebra has completely fallen off the next vertebra.
National Health Service UK, 2019
Catherine Burt Driver, MD
TYPES OF SPONDYLOLISTHESIS
1. Congenital – familial
2. Isthmic – common among adolescents associated with backpains.
3. Degenerative – common among women above 50 years old
4. Traumatic – caused mostly by accidents
5. Pathologic – tumors, infection or cancer in origin
6. Iatrogenic - idiopathic
 SYMPTOMS
• lower back pain – which is usually worse when you're active or when you're
standing, and is often relieved by lying down
• pain, numbness or a tingling feeling spreading from your lower back down
your legs (sciatica) – this happens if the bone in the spine presses on a nerve
• tight hamstring muscles
• stiffness or tenderness in your back
• curvature of the spine (kyphosis)

The severity of these symptoms can vary from person to person.

 CAUSES OF SPONDYLOLISTHESIS
• a birth defect in part of the spine – this can cause it to slip forward
• repetitive trauma to the spine – this results in a defect developing in the spine,
which can cause it to slip; it's more common in athletes such as gymnasts and
weightlifters
• the joints of the vertebrae becoming worn and arthritic – this is more common
in older people
• a sudden injury or trauma to the spine – such as a fracture, which can result in
the vertebra slipping forward
• a bone abnormality – this can be caused by a tumor, for example
DIAGNOSTIC PROCEDURES
• X-rays
• CAT/CT scan
• MRI scan
• In most cases, it is easily seen on regular X-rays of the low
back.

University of Maryland Medical Center, 2003

MEDICAL MANAGEMENT
• a short period of rest, avoiding activities such as bending, lifting, contact
sports, and athletics
• Non-steroidal anti-inflammatory painkillers, such as ibuprofen
• physiotherapy – simple stretching and strengthening exercises may help
increase the range of motion in your lower back and hamstrings
• if you have pain, numbness and tingling in your legs, corticosteroid injections
around the compressed nerve and into the center of your spine may be
recommended
SURGICAL MANAGEMENT
• laminectomy – where a section of bone is removed from 1 of your
vertebrae (spinal bones) to relieve pressure on the affected nerve
• discectomy – where a section of a damaged disc is removed to
relieve pressure on a nerve
• spinal fusion – where 2 or more vertebrae are joined together with a
section of bone to stabilize and strengthen the spine.

In many cases, a combination of these techniques may be used.