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Lumbar Spondylolisthesis Treatment in New Jersey

Spondylolisthesis is a condition that can affect young people as well as older adults. While some cases are mild, others can cause chronic lower back pain and nerve-related issues such as tingling and numbness. Learn about lumbar spondylolisthesis causes, symptoms, and treatment options from Centers for Neurosurgery, Spine & Orthopedics (CNSO). Located in northern New Jersey, CNSO is the state’s most comprehensive spine care center, offering expertise in a wide range of back and spine conditions.

What Is Lumbar Spondylolisthesis?

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Spondylolisthesis is a spine condition that develops when one vertebra slips forward or backward over the vertebra that sits below it. While spondylolisthesis can happen anywhere along the spinal column, it is most common in the lower back, or lumbar spine.

Anatomy of the Lumbar Spine

The spinal vertebrae are divided into three main sections: the cervical, thoracic, and lumbar spine. The lumbar spine, located in the lower back, consists of five vertebrae (L1 – L5) that sit above the sacrum and coccyx. The vertebrae in the lumbar spine are larger than those in the thoracic and cervical spine. The lumbar spine helps to stabilize the back, provide balance, and support the upper body when bending and lifting.

Types of Spondylolisthesis

Types of spondylolisthesis include:

Degenerative Spondylolisthesis

This form of spondylolisthesis is caused by long-term wear and tear on the spine. As a person ages, the cartilage that cushions their joints can begin to break down, leading to osteoarthritis and disc degeneration. As the intervertebral discs that cushion the spine wear out, the lumbar vertebrae are more at risk of slipping out of place.

Isthmic Spondylolisthesis

This type of spondylolisthesis is caused by a stress fracture of the pars interarticularis, the thin layer of bone that connects the facet joints in the spine. While isthmic spondylolisthesis often develops during childhood, symptoms may not appear until the patient reaches adulthood.

Congenital Spondylolisthesis

Present from birth, congenital spondylolisthesis develops when a person’s bones do not form correctly during fetal development. It also is known as dysplastic spondylolisthesis.

Traumatic Spondylolisthesis

This form of spondylolisthesis is caused by sudden, acute trauma that results in spinal fractures, such as a car accident or sports injury. These fractures can misalign the spine, resulting in vertebrae that slip out of place.

Prevalence and Risk Factors

According to the American Academy of Orthopaedic Surgeons, spondylolisthesis and spondylolysis affect approximately 4% to 6% of people in the United States. Spondylolysis is a stress fracture through the pars interarticularis (a thin bone segment joining two vertebrae) of the lumbar vertebrae. Risk factors for spondylolisthesis include:
  • Gender: Degenerative spondylolisthesis is more common among women than men.
  • Athletic activity: Young athletes who play certain sports that hyperextend the lumbar spine, such as gymnastics and football, are more likely to develop spondylolisthesis.
  • Age: The risk of degenerative spondylolisthesis increases after the age of 50.
Additionally, some patients are genetically predisposed to isthmic spondylolisthesis because they are born with thinner pars interarticularis.

Identifying Symptoms and Diagnosis

Some patients with spondylolisthesis do not experience any symptoms. While lower back pain and stiffness are the most common signs of spondylolisthesis, other symptoms include:
  • Pain that radiates into the buttocks or thighs
  • Pain that is worse at night
  • Numbness, tingling feelings, or weakness in one or both feet
  • Difficulty standing for long periods
  • Muscle tightness or spasms in the hamstrings
Patients typically are diagnosed with spondylolisthesis after a thorough physical examination and imaging tests. These may include X-rays, magnetic resonance imaging (MRI), or computed tomography (CT) scans.

Grading Spondylolisthesis

A common method for assessing the severity of spondylolisthesis is the Meyerding Grading System. With Grade I being the least severe and Grade V being the most severe, the grading system measures the degree of vertebral slippage:
  • Grade I: 1-24%
  • Grade II:25-49%
  • Grade III:50-74%
  • Grade IV: 75-99%
  • Grade V: 100%, known as spondyloptosis

Conservative Treatments

CNSO values a conservative approach to treatment throughout the patient journey, from pain management and physical therapy to surgery if necessary. The comprehensive team at CNSO includes orthopedic spine surgeons, neurosurgeons, physiatrists, rehabilitation specialists, and certified physical therapists working together to ensure appropriate, personalized care. Conservative treatment options for spondylolisthesis include:

Bracing and Orthotics

Another non-surgical treatment for patients with spondylolisthesis is the use of braces and orthotic devices. These can help stabilize the spine and limit movement while vertebral fractures heal. While braces can be helpful for children and teens with isthmic spondylolisthesis, they are not effective for other types of spondylolisthesis.

Surgical Options

Grade I and II cases of spondylolisthesis usually can be managed with conservative treatments. For more severe cases of spondylolisthesis causing significant pain that does not resolve after conservative intervention, back surgery may be the best option. Types of surgery include:

Spinal Fusion Surgery

In this procedure, a spine surgeon permanently connects two affected vertebrae using a bone graft. As the vertebrae heal, they fuse into one bone. Fusion surgery stabilizes the spine but can also limit the patient’s range of motion.

Spinal Decompression Surgery

Decompression surgery relieves pressure on the nerves by creating space in and around the spinal canal. During decompression surgery, a neurosurgeon may remove a portion of a diseased disc (known as a discectomy) or part of the lamina (a laminectomy). Decompression treatment may be performed as a standalone procedure or in combination with fusion surgery.

Post-Surgery Care and Recovery

Complete recovery from spinal fusion surgery can take up to a year, although most patients can do light activities after a few weeks. As part of their post-surgical rehabilitation, most patients will see a physical therapist. Participating in physical therapy will help a patient heal from surgery faster, reduce post-operative pain, and improve strength and flexibility in the back. While spondylolisthesis can reoccur, regular monitoring appointments can catch any minor back issues before they get worse.

Preventive Measures

It may not be possible to prevent spondylolisthesis, but patients can reduce their risk with lifestyle modifications. Exercising regularly, maintaining a healthy weight, and eating a balanced diet all can help a person care for their spine. Additionally, using good ergonomic practices can reduce strain on the spine whether a patient has an office job or performs physical labor.

Coping With Chronic Pain and Disability

Conditions that affect the spinal nerves, like spondylolisthesis, can result in chronic pain that may be difficult to treat. For patients with long-term chronic pain, developing adaptive strategies can be helpful. Chronic pain also can begin to affect a patient’s mental health, so providers should connect patients to mental health resources and support services when needed.

Frequently Asked Questions About Lumbar Spondylolisthesis

What Causes Lumbar Spondylolisthesis?

Lumbar spondylolisthesis can develop due to degeneration in the spine or from a stress fracture in the vertebrae. Spondylolisthesis also can be congenital (present at birth).

Can Lumbar Spondylolisthesis Be Treated Without Surgery?

Non-surgical treatments cannot correct vertebral slippage, but they can relieve symptoms. These pain management treatments include oral medications, steroid injections, and physical therapy.

Is Lumbar Spondylolisthesis a Progressive Condition?

Lumbar spondylolisthesis may get worse over time as the degenerative conditions that cause it, like osteoarthritis, progress.

Trust CNSO for Lumbar Spondylolisthesis Treatment

With any condition that affects the spine, following proper medical guidance is crucial. At CNSO, patients can receive comprehensive treatment for spondylolisthesis from a team of experienced, board-certified spine specialists, neurosurgeons, pain management physicians, and certified physical therapists. CNSO has convenient locations throughout northern New Jersey, serving patients in Bergen, Passaic, Essex, Morris, and Hudson counties and the surrounding areas. To schedule a consultation, contact CNSO today.

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