Spondylolisthesis
Serving the South Florida and Orlando Areas
Dr. Andreas C. Tomac, MD, PhD, FAANS is a distinguished neurosurgeon specializing in diagnosing and treating Spondylolisthesis.
What is a Spondylolisthesis?
Spondylolisthesis is a spinal condition characterized by the forward displacement of one vertebra over an adjacent vertebra. This displacement can occur in various regions of the spine, but it most commonly affects the lumbar (lower back) region. The condition may be caused by a defect or fracture in the pars interarticularis, a small bony segment that connects the facet joints at the back of the spine. Spondylolisthesis is often classified into different grades based on the extent of vertebral displacement. Common symptoms include lower back pain, stiffness, and in more severe cases, nerve compression leading to leg pain or weakness.
Who can it affect?
Spondylolisthesis can affect individuals across a broad demographic spectrum, including various age groups and backgrounds. While it is more commonly observed in adolescents and young adults, particularly those engaged in activities that involve repetitive stress on the spine, such as gymnastics or football, it can also affect older adults due to age-related degenerative changes in the spine. Certain factors may contribute to the development of spondylolisthesis, including genetic predisposition, repetitive trauma, or specific anatomical variations. Additionally, conditions such as spondylolysis, a defect or stress fracture in the pars interarticularis, can increase the risk of spondylolisthesis. As spondylolisthesis can lead to varying degrees of pain and discomfort, individuals experiencing persistent lower back pain or related symptoms should seek medical evaluation. Orthopedic surgeons or neurosurgeons are typically involved in the diagnosis and management of spondylolisthesis, tailoring treatment plans based on the specific characteristics of the condition and the individual’s overall health.
What are the symptoms?
Symptoms of spondylolisthesis can vary based on the degree of vertebral slippage and the impact on surrounding structures. Common symptoms may include:
- Lower Back Pain: Persistent pain in the lower back, particularly at the site of vertebral slippage, is a common symptom.
- Stiffness: Stiffness and reduced flexibility in the lower back may be experienced, especially after periods of inactivity.
- Radiating Leg Pain: If the slippage compresses nearby nerves, individuals may experience radiating pain, numbness, or tingling in the legs.
- Muscle Tightness: Tightness or spasms in the muscles surrounding the affected vertebrae may occur.
- Changes in Gait: In some cases, spondylolisthesis can lead to changes in walking patterns or difficulty walking.
- Weakness: Weakness in the legs or difficulty with coordination may be present, particularly if nerve compression is significant.
It’s important to note that some individuals with spondylolisthesis may not experience noticeable symptoms, while others may have severe discomfort. Seeking medical evaluation, especially for persistent or worsening symptoms, is crucial for an accurate diagnosis and the development of an appropriate treatment plan. Orthopedic surgeons or neurosurgeons typically play a key role in diagnosing and managing spondylolisthesis.
Treating Spondylolisthesis
How is Spondylolisthesis diagnosed?
Diagnosing spondylolisthesis involves a comprehensive evaluation, and a neurosurgeon like Dr. Tomac can play a crucial role in this process. Dr. Tomac typically begins by obtaining a detailed medical history, including information about the onset and characteristics of symptoms, any relevant trauma, and the patient’s overall health. A thorough physical examination assesses the range of motion, stability, and neurological function of the spine. Imaging studies, such as X-rays, Magnetic Resonance Imaging (MRI), or Computed Tomography (CT) scans, are essential to visualize the spine and assess the degree of vertebral slippage. Dr. Tomac’s expertise in neurosurgery allows for a precise analysis of imaging results, aiding in the accurate diagnosis of spondylolisthesis. The collaboration between the patient and Dr. Tomac is crucial in determining the severity of the condition and developing an individualized treatment plan tailored to address the specific characteristics of the spondylolisthesis. Seeking timely medical attention is essential for an accurate diagnosis and appropriate management of this spinal condition.
What treatments are available?
The treatment of spondylolisthesis can involve a range of approaches, and a neurosurgeon like Dr. Tomac can provide expertise in both non-surgical and surgical interventions. Treatment options include:
- Conservative Measures:
- Physical Therapy: Targeted exercises to strengthen the core muscles and improve flexibility, aiming to stabilize the spine.
- Bracing: In certain cases, a brace may be recommended to provide support and limit movement during the healing process.
- Pain Management: Medications or injections to manage pain and inflammation.
- Surgical Interventions:
- Laminectomy: Removal of the lamina (part of the vertebral bone) to relieve pressure on nerves.
- Spinal Fusion: Surgical procedure to stabilize the spine by fusing vertebrae together.
- Decompression: Surgical removal of tissue or bone causing compression of nerves.
Dr. Tomac can assess the specific case, discuss treatment options, and recommend the most appropriate course of action based on the severity of spondylolisthesis and the individual’s overall health. Surgical intervention is typically considered for severe cases or those associated with neurological deficits. The decision on the most suitable treatment plan is made collaboratively between the patient and Dr. Tomac, considering the unique circumstances and goals of the individual. Seeking timely medical attention allows for a comprehensive evaluation and the development of an individualized treatment strategy for spondylolisthesis.