Spondylolisthesis is a condition in which damage to bones or facet joints cause a vertebra to slip forward distorting and/or compressing the spinal cord or spinal nerves. Spondylolisthesis is generally categorized as either degenerative or isthmic. Spondylolisthesis can occur in both the cervical or lumbar spine but is more common in the lumbar spine especially at the L4-L5 level near the bottom of the lumbar spine.
Degenerative Spondylolisthesis occurs when the facet joints of the vertebra of the spine weaken, allowing a one vertebra to slip forward relative to the one below. As a result of this forward slip, nerve roots may become pinched between the two displaced vertebra, causing radicular or sciatic pain to radiate to the legs and feet.
Isthmic spondylolisthesis (also call spondylolysis) occurs when vertebral bone fractures disconnecting the posterior facets from the vertebral body at the pars portion that allows the forward slip to occur. This can also pinch nerve roots, causing pain to radiate to the legs and feet.
It has been noted that some athletes are more prone to Spondylolisthesis specifically, athletes like gymnasts, football players, hockey players and other contact sports. This increased incidence is most likely as a result the repetitively concussive nature of their sport causing microfractures of the vertabrae and facet joints. Over time these microfractures weaken the spinal structures, causing a Spondylolisthetic defect. It is notable that the majority of spondylolysis pars fractures occurs in the teenage years but do not become symptomatic until 40s to 60s when the slip increases along with degenerative changes.
Spondylolisthesis can occur in both the cervical or lumbar spine
Spondylolisthesis symptoms can include:
- Back or neck pain
- Pain that radiates into the extremities
- Numbness or tingling in the extremities
- Weakness of the extremities
- Bowel or bladder incontinence