Spondylytic spondylolisthesis is a condition where one vertebra slips relative to the adjacent vertebra due to a defect or fracture in the pars interarticularis, a small bridge of bone connecting the upper and lower facet joints of a vertebra.
It is commonly observed in young athletes in sports that involve repetitive extension such as gymnastics. The primary cause spondylolisthesis is a stress fracture in the pars interarticularis, often resulting from overuse or repetitive strain. Genetic factors may also play a role, as some individuals have a predisposition to develop this condition.
What are the symptoms of spondylytic spondylolisthesis?
Lower back pain which usually worsens with activity and improves with rest, is typical. Nerve pain which radiates to the buttocks, thighs and legs may also be present as well as numbness or pins and needles. In severe cases muscle weakness may also occur.
How is spondylytic spondylolisthesis diagnosed?
Following a thorough clinical assessment you will be referred for an Xray and a CT or MRI scan. These investigations will confirm the presence of the spondylolisthesis and the amount of vertebral slippage and nerve compression that is present. In some cases epidural nerve injections may help to confirm the diagnosis.
What are the treatment options for spondylytic spondylolisthesis?
Non operative treatments including rest and physical therapy, and anti-inflammatory or anti-neuropathic medications to relieve pain and improve function. If symptoms persist, surgical intervention may be indicated. The goals of surgery are to decompress the spinal nerves and stabilise the vertebrae which 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.
