What is spondylolisthesis?

Spondylolisthesis is a common spinal disease. On spondylolisthesis, a vertebra shifts on the other vertebra by sliding forward or backward. Spondylolisthesis can be treated by physiotherapists, orthopedics and neurosurgeons. In the case of spondylolisthesis, whether the procedure is performed non-operatively or surgically depends on the degree of the slip and whether the slip is moving or immobile. Slipped spondyle presses spinal cord and nerve roots coming from it. This causes complaints such as pain in the waist and gluteus, contraction in the back muscles, numbness and weakness in the legs. The complaints increase with standing and walking.

Causes of spondylolisthesis

Spondylolisthesis can occur congenitally, post-traumatic and due to calcification of the spine. Lumbar spondylolisthesis can develop in the congenital pathologies of the joints and ligaments that hold the vertebrae in one line and in a certain alignment. Congenital spondylolisthesis are noticed during the period of growth and development. The operation is not performed in the spondylolisthesis that are noticed during the development period.

Spondylolisthesis can be seen following trauma such as traffic accidents, high falls, serious sports injuries, overloading of the belly. Fractures of the spine bones are also commonly accompanied by lumbar spondylolisthesis. The treatment of this type of spondylolisthesis is the surgery.

Another reason for spondylolisthesis is calcification of the spine over 40 years. This type of spondylolisthesis is most commonly seen in the waist region, slipping of the 4th vertebrae over the 5th vertebrae.

Diagnosis of spondylolisthesis

The diagnosis of spondylolisthesis is usually made by a neurosurgeon or orthopedic or physical therapist. With the knowledge of the detailed physical examination and imaging methods to be done, the diagnosis of spondylolisthesis can be made easily. X-rays, tomography, scintigraphy and MR waist slip are frequently required tests to determine the cause and to plan the treatment.

Spondylolisthesis Treatment

If the waist slip is tractable and the examination does not reveal any pressure on the spinal cord or nerve roots, non-operative treatment methods such as pain relievers, use of corset, physical therapy and various injections to the waist will be enough.

Surgical treatment options may be considered in patients who do not improve their complaints with non-surgical methods. If the spondylolisthesis causes pressure on the spinal cord and nerve roots causing power loss in muscles, walking impairment, urinary incontinence, then surgery should be done without loss of time.

Surgery for Lumbar Spondylolisthesis

Patients who have low quality of life due to back pain in the spondylolisthesis, who have walking at a distance of less than 500 meters and who develop weakness in their legs due to spinal cord compression are operated. If there is a fracture in the spondylolisthesis, two kinds of surgery can be performed. Repair of the fractured area or spinal fusion surgery are surgical treatment methods applied to the spondylolisthesis.

In the spinal fusion surgery, the pressure of the bone structures due to the spondylolisthesis is removed surgically and then lumbar vertebrae are fixed via the titanium screw rod system, which is known as platinum insertion publicly. Surgery for lumbar spondylolisthesis can be performed from the front or back. Frontal operations are more difficult. The goal is to prevent further slippage of the slipped lumbar vertebrae and not to replace sliding vertebrae. The operation is about 3-4 hours.

After the surgery, patients can walk in the next day after surgery, walk comfortably after 1 week, and return to their daily lives in about 1-2 months depending on the weight of their profession. After surgery, tractable power losses recover in a short time, but long lasting power failures may not improve. If needed, physical therapy and rehabilitation should be performed after the surgery for lumbar spondylolisthesis.



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