Spondylolisthesis

Spondylolisthesis is the condition in which one vertebral body is slipped forward over another. Spondylolisthesis is most likely caused by an underlying condition of spondylolysis. There are different types of spondylolisthesis, including degenerative, isthmic, dysplastic, traumatic, and pathologic. Isthmic Spondylolisthesis is the most common cause of back pain in adolescents and the typical symptom is back and/or leg pain that limits a patient's activity level. Patients with spondylolisthesis are often advised not to participate in rigorous activity such as sports in order to avoid neurological damage or paralysis, but cases are rare and for the most part, it is not a dangerous condition. Most adolescents with spondylolisthesis do not actually experience any symptoms or pain.

SYMPTOMS

• Lower back pain and/or leg pain are the most typical symptoms of degenerative spondylolisthesis. Some patients do not have any back pain with degenerative spondylolisthesis and others have primarily back pain and no leg pain.
• Patients often complain of sciatic pain, an aching in one or both legs, or a tired feeling down the legs when they stand for a prolonged period of time or try to walk any distance (called pseudoclaudication).

CAUSES

• Every level of the spine is composed of a disc in the front and paired facet joints in the back. The disc acts as a shock absorber in between the vertebrae, whereas the paired facet joints restrain motion. They allow the spine to bend forwards (flexion) and backwards (extension) but do not allow for a lot of rotation.
• As the facet joints age, they can become incompetent and allow too much flexion, allowing one vertebral body to slip forward on the other.