Arthritis of Lumbar Spine Spondylolisthesis | Barr Center

Lumbar Spondylolisthesis

What is arthritis of the lumbar spine (spondylolisthesis)?

This is a condition in which a spine vertebral body slips forward or backward upon the vertebral body below. The word is derived from the Greek words spondylos, which means “spine” or “vertebra,” and listhesis, which means “to slip or slide.” If the vertebra slips too far forward, it can cause pain and nerve damage. Spondylolisthesis may vary from mild to severe. It can cause postural changes as it progresses.

Who is affected by spondylolisthesis?

Both children and adults can be affected.

What causes spondylolisthesis?

In children it is usually due to a small stress fracture of the pars interarticularis of the fifth lumbar vertebra due to repetitive stresses on the region. This occurs in 3-5% of the US population. As a result the fifth lumbar vertebra may slip forward on the sacrum.

In adults, the slip is most frequently between the fourth and fifth lumbar vertebrae. Common causes can be related to:

Degenerative diseases, such as arthritis
Traumatic fractures
Bone diseases

What are symptoms of arthritis of the lumbar spine (spondylolisthesis)?

Symptoms may include:

Pain in the lower back, thighs, and buttocks
Stiffness in the back
Muscle tightness
Tenderness in the slipped area
Neurological damage (leg weakness or changes in sensation) may result from pressure on nerve roots and may cause pain radiating down the legs
Localized tenderness over the spine just above the pelvis

Some patients may not exhibit any symptoms with spondylolisthesis.

How is spondylolisthesis diagnosed?

X-rays will reveal the misalignment of the vertebra, and they can also show if there are any fractures.

How is it treated?

The most common treatments for spondylolisthesis are:

Strengthening and stretching exercises
Modification of activities
Avoiding hyperextension of the back
Avoiding contact sports
Rigid brace when deemed necessary
Surgery for the more severe cases to fuse the slipped vertebra

What are complications related to spondylolisthesis?

Nerve compression
Temporary or permanent damage of spinal nerve roots, which may cause sensation changes or weakness
Chronic back pain

What can be done to help prevent further complications with

spondylolisthesis?

Avoid back hyperextension (leaning too far back)
Avoid weightlifting
Avoid contact sports
Seek medical attention if your child complains of back pain or stiffness, or pain in the thighs and buttocks.

If these techniques do not bring about the desired pain relief, we may perform a facet joint injection, which delivers a steroid or anesthetic to reduce inflammation and pain. It will also help to better diagnose the problem. We may also recommend other types of procedures such as medial branch blocks (diagnostic only) or prolotherapy.

If the facet joint injection provides temporary but not long-lasting relief, your physician may discuss the option of radiofrequency (lesioning) of the small nerves, which provide nerve impulses to the facet joints believed to cause your pain.