It might be a mouthful to pronounce, but spondylolisthesis (spon-dee-low-lis-thee-sis) is a condition that occurs in approximately 4-8% of the population. The condition involves a forward slippage of a vertebra, usually due to a non-united childhood fracture in the spine.
The fracture occurs at the pars interaticularis, which sits between the main body at the front of the spine (vertebral body) and the section at the very back that can be felt through the skin (spinous process). 90% of these fractures occur at L5 (vertebra at the base of the low back) and 5%occur immediately above at L4.
The pars interarticularis is the thinnest and weakest part of the lumbar spine and therefore prone to fracture from forced forward bending or rotation. In some cases, the defect is an elongation, rather than a complete fracture, that causes the vertebra to slip forward.
In most cases it is repeated microtrauma, rather than a single onset that creates the spondylolisthesis. Activities such as gymnastics and wight lifting may be causative factors. Most chiropractors will advise caution with having young babies in walkers and ‘Jolly Jumpers’ before they are able to support their own weight as this may also be a contributing cause. Having a baby upright in a Jolly Jumper before they have developed the forward lumbar curve (12-18mths) places increased stress on the low back.
In most cases, a spondylolisthesis will not cause significant pain, especially in the early years of development. If symptoms do develop, it is usually related to the shearing stress on the disc that can cause the disc to prolapse. Other complications include degeneration of the facet joints or narrowing of the spinal canal (spinal stenosis). Leg pain is not an uncommon finding with a symptomatic spondylolisthesis.
The treatment for spondylolisthesis depends on the severity of the forward slip. Inmost cases the slip will be Grade I or Grade II. In these cases, the vertebra has slipped forward by less than 50%. These patients typically respond well to chiropractic care, exercise and, if necessary, modified activity. A Grade III or Grade IV spondylolisthesis will often require surgery.
If you’re experiencing spondylolisthesis and want to discuss treatment with your chiropractor, book online @ https://www.centenarychiro.com.au/ or call us today on 07 3381 0440
