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Spondylolisthesis Article by What is a Spondylolisthesis? Spondylolisthesis Spondylolisthesis refers to a slippage of a vertebral body relative to an adjacent vertebra. Spondylolisthesis (or anterolisthesis) is the forward displacement of a vertebral body in relation to the vertebrae beneath it. The slippage may occur following structural changes (eg fracture or ) or degenerative changes in the spine (eg or ). Approximately 5% of the population has a spondylolisthesis. Retrolisthesis is the opposite. The upper vertebral body is displaced backwards relative to the vertebrae below.

Laterolisthesis is a side ways shift that is rare. It can occur in advanced degenerative spines or after asymmetrical fractures or severe. Spondyloptosis refers to dislocated vertebrae.

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In these instances, your spondylolisthesis is so extensive that the upper vertebrae translates entirely forward and off the vertebrae below. See Grade V below. What are the Symptoms of Spondylolisthesis? Spondylolisthesis may not cause any symptoms for years (if ever) after the slippage has occurred. If you do have symptoms, they may include: • insidious onset low back pain, buttock or leg pain • pain arching your back • increased sway back • tight hamstrings - 80% of cases • a limp (walking). More severe cases are those that reproduce neurological signs eg • numbness, tingling, () pain, muscle tightness, muscle weakness in the leg and/or diminished reflexes. A step deformity may also be observed or palpated in the lower back.

What Causes a Spondylolisthesis? Isthmic vs Degenerative Spondylolisthesis The two major causes of spondylolisthesis are isthmic spondylolisthesis associated with and degenerative spondylolisthesis associated with degeneration of the posterior facet joints () and/or intervertebral disc (). Degenerative spondylolisthesis occurs mostly (88.5%) at the L4-5 level as opposed to isthmic spondylolisthesis, which occurs most often at the lumbosacral level (L5-S1) (84.6%). Approximately 75% of spondylolisthesis occur at L5 on S1 and 20% at L4 on L5.

One study showed that 26% had suffered a fall. Dysplastic & Other Spondylolisthesis Dysplastic or congenital spondylolisthesis is caused by poorly formed facet joint structure at birth leading to the vertebral slippage. Other causes related to traumatic or pathological fractures and post-surgical failure are rare. Spondylolisthesis and Your Age?

Congenital or dysplastic spondylolisthesis has an early childhood onset as mentioned above. Isthmic spondylolisthesis is more prevalent in the pre-teen and adolescent years in the athletic youth populations. Sports that involve hyperextension and rotation. Eg gymnastics, fast bowling (cricket), hurdling, tennis, wrestling and other throwing or overhead racquet sports are higher risks. (back stress fracture) initially occurs and about 50% of cases slip to develop into a spondylolisthesis. Most isthmic spondylolisthesis stabilise at skeletal maturity.

The fractures themselves may not heal but it is thought that the muscles controlling the spondylolisthesis provide sufficient functional control to avoid painful symptoms. Download lagu jepang. Degenerative spondylolisthesis is more common with advancing age.

The vertebrae slip forwards without a fracture present. The slippage is related to chronic spinal segment instability due co-existing pathologies such as or ().

They are also more likely to cause recurrent symptoms. Due to the whole vertebrae and arch slipping forwards degenerative spondylolisthesis can cause spinal and compromise spinal nerve roots. Compromise of the spinal nerve roots may result in a radicular pain syndrome such as or significant develop motor power deficits (radiculopathy). In extreme cases, the stenosis and slippage could compromise the cauda equina and develop cauda equina syndrome, which is a medical emergency and will require immediate surgical intervention. Spondylolisthesis Risk Factors Known risk factors include: • Sports involving hyperextension and rotation • Genetic predisposition. You have a 26% chance if a parent has one. • Spondylolisthesis: Females 2-3 times • (no slip): Males 2-3 times • Generalised hypermobility.

• Spina bifida occulta • Facet joint morphology • Inuit population • Degenerative spondylolisthesis is more prevalent in pregnant women and black individuals. How is Spondylolisthesis Diagnosed?

Your physiotherapist will begin by taking a history and performing a physical examination. A palpable step or depression may be present to indicate the likelihood of a spondylolisthesis. Your physiotherapist may order X-rays of your back. A CT scan or MRI scan can show a fracture or pars defect more clearly, plus exclude other potential pathologies such as malignancy, infections or spinal stenosis. They will also show whether any of the nearby facet joints or discs have suffered any degeneration. If a spondylolisthesis is present, it is graded as I (mild), II, III, IV or V based on how far forward the vertebra has slipped.