Degenerative spondylolisthesis is a condition where one vertebra slips relative to the adjacent vertebra, causing a variety of symptoms.
It is more common in older adults as a result of osteoarthritis of the spine. Degeneration of the joints at the back of the vertebra (facet joints) and intervertebral disc causes a variable degree of slippage. This may cause the spinal canal to become narrow (spinal stenosis).
What are the symptoms of degenerative spondylolisthesis?
Symptoms of degenerative spondylolisthesis include lower back pain, and if there is spinal stenosis and nerve compression there may be pain, numbness and in some cases weakness that affects the legs. These symptoms are often precipitated by standing or walking and may be relieved by sitting or bending forward.
How is degenerative spondylolisthesis diagnosed?
Following a thorough clinical assessment you will be referred for an MRI scan and Xray. These investigations will confirm the presence of the spondylolisthesis and the amount of slippage.
What are the treatment options for degenerative spondylolisthesis?
Treatment is typically on a bespoke basis. Non – operative treatments are aimed at relieving symptoms and improving function. These include physical therapy to strengthen core muscles, and anti-inflammatory and anti-neuropathic medications. Epidural steroid injections may also be used to alleviate persistent pain.
If non-operative methods are ineffective, or significant neurological symptoms are present, surgery is indicated. Surgery involves decompression of the spinal nerves leading to improved function and alleviation of symptoms. In certain cases, stabilisation of the vertebrae is required, and this is achieved by performing a spinal fusion. This involves placing screws and rods into the spine, removing the intervertebral disc and replacing it with a fusion ‘cage’. This stabilises the vertebrae, preventing further slippage.
