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Spondylolisthesis

definition
Spondylolisthesis is a spinal condition that
affects the lower vertebrae (spinal bones). This
disease causes one of the lower vertebrae to slip
forward onto the bone directly beneath it. It’s a
painful condition but treatable in most cases.
Epidemiology
• Spondylolisthesis is the most common cause of back pain in
teens.
• Symptoms of spondylolisthesis often begin during the teen-
age growth spurt.
• Degenerative spondylolisthesis occurs most often after age
40.
Etiology
• Causes of spondylolisthesis vary based on age, heredity, and
lifestyle. Children may suffer from this condition as the result
of a birth defect or injury. However, people of all ages are
susceptible if the condition runs in the family. Rapid growth
during adolescence may also be a contributing factor.
• Playing sports may also cause your strain to overstretch and
put stress on your lower back. The following sports are
especially likely to cause this condition:
– football
– gymnastics
– track and field
– weightlifting
• Spondylolysis is often a precursor to spondylolisthesis.
Spondylolysis occurs when there is a fracture in a vertebra,
but it hasn’t yet fallen onto a lower bone in your spine.
Symptoms
The symptoms of spondylolisthesis vary. People with mild cases
may not have any symptoms. However, those with severe cases
may be unable to perform daily activities. Some of the most
common symptoms are:
• persistent lower back pain
• stiffness in your back and legs
• lower back tenderness
• thigh pain
• tight hamstring and buttock muscles
Diagnosis
• Anamnesis
• Physical exam
– have difficulty raising the leg straight outward
during simple exercises
• X-rays
• CT scan
treatment
Common nonsurgical treatment methods include:
• wearing a back brace
• doing physical therapy exercises
• taking over-the-counter or prescription anti-inflammatory drugs (such as
ibuprofen) to reduce pain
• using epidural steroid injections
• The American Academy of Orthopaedic Surgeons recommends trying
nonsurgical treatments first. However, adults suffering from severe cases
of spondylolisthesis may need to have a surgery called a spinal fusion.
Surgical correction of the misplaced vertebra is required when the bone has
slipped so far down that your spine doesn’t respond to nonsurgical therapies.
Surgery is also required if the bones of your spine are pressing on your
nerves.

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