Instability of the vertebral joints and progressive degenerative changes can lead to displacement of the vertebrae. This condition is known as spondylolisthesis. The lumbar spine is often affected.
Here you will find further information and selected spondylolisthesis specialists and centers.
Spondylolisthesis is a condition in which the vertebral bodies of the spine shift against each other. Spondylolisthesis usually occurs in the lumbar spine. In severe cases, individual vertebral bodies can even pinch the spinal nerves in the lower spinal cord. The pinching of nerves often causes considerable pain or sensorimotor deficits.
Slipping over a long period of time causes adhesions in the posterior vertebrae. As a result, the statics of the spine can partially strengthen and thus stabilize itself.
Many patients do not experience any symptoms at all due to spondylolisthesis. This is referred to as asymptomatic spondylolisthesis, i.e. spondylolisthesis without symptoms.
Patients with symptomatic spondylolisthesis can be severely restricted in their mobility. In some cases, they suffer from severe pain that is dependent on strain and position.
In most cases, the symptoms can initially be treated conservatively (without surgery). Surgery is only necessary in very severe cases of spondylolisthesis.
The attending physician decideswhether treatment isnecessary. The indication for surgical treatment always depends on
findings.
In spondylolisthesis, individual vertebral bodies shift relative to the neighboring vertebrae © Henrie | AdobeStock
The specialist responsible for diagnosing spondylolisthesis is the spine specialist (usually a neurosurgeon or orthopaedic surgeon).
Necessary operations are performed by a specialist in neurosurgery, orthopaedics or trauma surgery.
The spine carries the entire weight of the body and holds it upright. Overloading can cause a vertebra to slip out of place. This happens above all when
are weakened
The most common cause is degenerative damage to the vertebrae. With increasing age, there is a loss of fluid in the intervertebral discs, which reduces their height. The vertebral bodies move closer together and the function of the muscles and ligaments is impaired. In untrained people, this leads to poorer compensation for disc damage.
A high load and hyperextension of the spine backwards can lead to isthmic spondylolisthesis. Weightlifters and javelin throwers are particularly frequently affected. Injuries to the spine also reduce its stability and can lead to the disease.
In some cases, the disease is congenital. The triggers for this are still relatively unknown. However, there are familial clusters. This means that first-degree relatives of an affected person have an increased risk of also developing the disease.
Boys are affected three to four times more frequently than girls. However, the progression is more pronounced in girls.
According to the German Society for Orthopaedics and Orthopaedic Surgery, up to forty percent of Germans are affected by spondylolisthesis. However, the severity is often mild.
Affected patients often suffer from pain that intensifies with certain movements. It often spreads from the back to the front and is felt like a girdle. Some sufferers also have the feeling of a certain instability of the spine.
When the back muscles are relaxed in the morning, the pain is more severe. Pinching of a nerve root can also lead to sensory and/or motor disorders in the legs.
A brief overview of the symptoms:
If the disease is very advanced
may occur. However, these tend to be exceptional cases.
In some cases, spondylolisthesis remains symptom-free. Treatment should be discussed with the doctor. Treatment may not be necessary as long as there is no pain.
Anyone who frequently suffers from back pain should consult their family doctor. If spondylolisthesis is suspected, they will refer their patient to a spinal specialist.
Only in rare cases is spondylolisthesis an emergency that requires immediate treatment in a clinic. Emergencies that need to be examined immediately are
The diagnosis begins with an anamnesis, i.e. a patient interview, where the doctor will inquire about the patient's complaints and medical history:
This is followed by a physical examination.
The doctor now checks the patient's mobility. He pays attention to whether the patient is supporting himself or appears unsteady.
He also examines the course of the spine. This will reveal any misalignments, for example an S-shaped curve, which indicates scoliosis. A hunchback phenomenon can also be recognized if a hump can be seen in the course of the spine. Such steps are usually detected by palpating the spinous processes (posterior processes of the vertebrae).
The doctor identifies painful regions by pressing and tapping. The position of the pelvis and the muscle status around the spine are also checked during the examination.
The function of the spine can be checked using the so-called Schober sign. To do this, the examiner marks a point every ten centimetres, starting from the upper coccyx angle. If the patient bends forward, he or she will recognize the restriction of mobility.
Even more specific examinations depend on the patient's symptoms.
In order to obtain an accurate picture of the disease, X-rays are taken from two different planes. Sometimes the doctor also
is carried out. This allows the intervertebral discs and bones to be assessed more precisely.
In order to assess whether a dynamic listhesis component is present, conventional lumbar functional images in reclination and inclination are often also useful.
According to Meyerding, spondylolisthesis is divided into four different degrees of severity.
If a vertebra becomes completely detached, this is referred to as spondyloptosis.
The symptoms and complaints depend on the degree of severity. With early treatment, the chances of alleviating symptoms are very good.
The main aim is to relieve the affected person of their pain and thus ensure a better quality of life. This is achieved by stabilizing the vertebrae.
Spondylolisthesis therapy consists of two cornerstones:
In mild cases, conservative treatment is usually sufficient. Only in very severe cases should surgical intervention be considered.
First of all, a thorough examination is followed by a detailed consultation. The doctor will explain to the patient how they can relieve the pressure on their spine. In most cases, this alone leads to a significant improvement in symptoms.
The patient must avoid overstretching the spine by doing certain types of sport. If the patient is overweight, weight reduction is recommended. This reduces the strain on the spine.
Medication can also help. Various painkillers can be used effectively against the pain. Muscle relaxants and anti-inflammatory medication are also available.
The guarantee for a stable spine is strong muscles that counteract spondylolisthesis.
The best way to achieve this is through targeted gymnastics and, above all, regular daily training of the back muscles.
Surgical intervention is only necessary in very severe cases. An operation stabilizes the vertebrae to ensure their correct position. An appropriate consultation will provide information and allay any fears about surgical treatment.
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