Spondylolysis (ICD code: M43.0) is hereditary in most cases. Even if the disease is congenital, it does not yet manifest itself in infants. It only develops over time. Children and adolescents between the ages of 12 and 17 are most frequently affected. The younger the child, the higher the probability of severe spondylolisthesis.
Alexandr Mitiuc / Fotolia
The disease can also be caused or exacerbated by
one-sided, chronic stress. The combination of genetic and mechanical factors proves to be particularly unfavorable. Competitive athletes with a
hollow back caused by sport suffer particularly frequently from spondylolysis. Typical sports that cause this are
- Wrestling,
- dolphin swimming,
- gymnastics,
- judo and
- ballet.
Due to the altered position of the vertebrae, they no longer grow evenly, but asymmetrically.
This leads to incorrect posture and uneven wear of the vertebral joints. This makes spondylolisthesis more likely. Spondylolisthesis can also be caused by accidents or bone diseases such as osteoporosis or degenerative changes.
Tumors or inflammation are extremely rare causes.
The disease affects the lumbar spine, rarely the cervical spine. Spondylolysis is classified into severity grades I to IV. Severity grade IV describes the complete tilting (sliding forward) of a vertebral body, which is, however, very rare. A variant of the clinical picture is the displacement of a vertebral body without cleft formation (pseudospondylolisthesis).
© Henrie / Fotolia
The following symptoms occur with
spondylolisthesis :
- Back pain on exertion that radiates into the buttocks and thighs.
- The pain increases when stretching (bending backwards): the spinal canal narrows as a result of this movement, pressure is exerted on the tissue and the bony processes touch each other.
- When bending forward, the pain decreases: bending relieves the pain as it widens the spinal canal slightly and the bony processes can move apart.
However, the disease can also be completely painless. It is then discovered by chance during an X-ray examination. If the muscles and ligaments around the spine provide compensatory stability, spondylolysis does not necessarily cause discomfort.
Spondylolysis should not be confused with a herniated disc , even if the symptoms are sometimes similar. The diagnosis can be made with a lateral X-ray of the spine. An MRI also reveals possible damage to the spinal cord and nervous system, and therefore a possible slipped disc, so that this diagnostic option is preferable to a simple X-ray.
Conservative treatment is sufficient for stage I and II symptoms. It should not be based solely on the X-ray image, but above all on the patient's symptoms.
In most cases, physiotherapy is prescribed, which is very effective. It is aimed at strengthening the abdominal and back muscles. Ideally, the treatment should be holistic. Good results are also achieved with massages, muscle-relaxing medication and electrotherapy.
However, if there are already neurological deficits such as paralysis of the legs, surgery may be considered. The slipped vertebra is brought back and stabilized(spondylodesis with reduction). After the operation, a stay of several weeks in a rehabilitation clinic is required.
© gewitterkind / Fotolia
Prevention is not possible in the case of genetic spondylolysis. However, something can be done for slipped vertebrae caused by wear and tear.
However, since pseudospondylolisthesis can be halted or prevented by training the spine, targeted muscle development is necessary. All muscles that support the skeleton should be strengthened.
The muscles located ventrally (towards the back) are also trained. Pilates and yoga in combination with a targeted strengthening program on equipment such as the MedX are also useful. The vertebrae cannot be brought back into their original position in this way. However, further deterioration is usually prevented or at least delayed.
Strong muscles stabilize the entire skeleton and generally prevent back pain. Strong muscles can also prevent age-related back problems.
