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Spondylolisthesis and spondylolysis are related but different conditions.
Spondylolysis is a crack or fracture of a vertebra, or bone, in the spine. It affects the lower back, the lumbar spine. Spondylolisthesis occurs when vertebrae slips forward over the vertebra below. Often the vertebrae that slips forward is above or below a cracked one; however, this can happen without spondylolysis as well.
In children and adolescents, spondylolysis usually occurs in those who play sports that put repeated stress on the lower back, such as gymnastics and football. It can also result from a spinal birth defect or trauma.
In adults, spondylolysis more often affects women and those who are 50 and older with conditions like arthritis.
Mild, Severe or No Symptoms
Symptoms for spondylolysis and spondylolisthesis can range from none to severe. Children may not have any symptoms until about age 18. Both conditions may not be noticed until it shows up in X-ray images for unrelated conditions.
Symptoms may include:
- Lower back pain
- Hamstring tightness
- Tingling, pain and numbness in the thighs and buttocks
- Tenderness near the affected vertebra
- Weakness in the legs
Diagnosing Spondylolysis and Spondylolisthesis
Your visit to the Orthopedic spine doctors at University of Maryland Orthopaedics will include an X-ray of your back. You may also have a bone density scan for osteoporosis, and a CT (computed tomography) scan or MRI (magnetic resonance imaging) to determine the severity and rule out other possible conditions.
Spondylolisthesis may improve by stretching and strengthening lower back muscles. If the injury is not severe, you can resume normal activities and non-contact sports. Other nonsurgical treatment may include:
- Rest – Avoiding activities that stress the lower back.
- Nonsteroidal anti-inflammatory drugs – Taking NSAIDs such as aspirin, ibuprofen and naproxen to reduce swelling and relieve pain.
- Physical therapy – Improving flexibility and strengthening the back and abdomen.
- Back brace – Wearing a brace to limit movement in the spine allows a fracture to heal.
Although these treatments can help you manage spondylolisthesis, it will not repair the fracture. You will have periodic X-rays to see if the vertebra is changing position.
Spinal Fusion Surgery for Spondylolisthesis
A spinal fusion, or lumbar laminectomy, may be needed to stabilize the spine and relieve pain. Surgeons will use natural bone or a synthetic to graft the two vertebras together. You may need surgery if you have:
- Severe pain that doesn't improve
- Severe slippage of a spine bone
- Weakness in one or both legs
- Difficulty controlling your bowels and bladder
You may spend up to three days in the hospital after surgery and begin physical therapy during your stay. Therapy will continue at home. You’ll have regular follow-up check-ups to ensure there is no recurrence.