14 Types of Spondylolisthesis
14 Types of Spondylolisthesis
Needless to say, your spine is an exceedingly complex structure. It’s composed of numerous moving parts that bear a continuous load. Just consider all the bending and flexing that your spine must do throughout the day. It’s no surprise, then, that the spine wears down over time.
It’s a natural fact of mechanics. Even when we take steps to slow down this process, ultimately some degree of degeneration will occur.
As such, there are a wide variety of potential problems that can affect the spine. Unfortunately, many of these conditions are not necessarily related to the degenerative process of aging.
Take spondylolisthesis, for example. Spondylolisthesis can be congenital in nature (i.e. present at birth) or may coincide with a traumatic event (such as an acute fracture in the neural arch).
Given this, there are many different ways to classify spondylolisthesis. Most commonly, doctors classify the condition based upon its cause. However, physicians may also categorize this type of injury or deformity based on the location of the affected site. And, lastly, you may hear your doctor refer to your condition by severity, a number denoting the degree of vertebral slippage.
Hankering for more? Continue reading for more information about spondylolisthesis.
However, don’t suffer unnecessarily from spondylolisthesis.
If you notice similarities between your case and the symptoms listed here, don’t hesitate to give Dr. Jason Lowenstein a call at (855) 220-5966. This is especially true if your symptoms have persisted for two weeks or longer despite pursuing conservative treatments.
Dr. Jason Lowenstein is one of the nation’s leading doctors in spinal deformity care. Furthermore, he specializes in minimally invasive surgical procedures designed to get you back to your normal routine as soon as possible. To request more information, contact us today!
What Exactly Is Spondylolisthesis?
In the vast majority of cases, spondylolisthesis describes a scenario in which a vertebra slips out of alignment. Generally, this is the result of spondylolysis or a fracture/crack in the thin part of a vertebral bone.
When this occurs, it may cause the vertebrae to slip forward, backward, or over the bone beneath it. When it comes to spondylolysis, children and teens are the most susceptible demographic for developing the condition. This is a natural byproduct of the fact that the body is still developing and is thereby more prone to this kind of injury. Of course, the risk of the condition occurring is also much more likely in those who play sports. For more on preventing spondylolisthesis in children, watch the video below:
As we have briefly mentioned, the causes of spondylolisthesis vary to a considerable degree. While this may be true, we can detect some common precipitating factors:
- Injury: Spondylolisthesis can easily arise from fractures or joint injuries resulting from arthritis or some other illness.
- Congenital: Sometimes, this condition may be present at birth. That is what congenital means.
- Tumors: Though not nearly as common as some of the other causes, tumors can occasionally lead to spondylolisthesis.
- Surgery: Sometimes, a failed surgical procedure may result in this condition.
As you can clearly see, there is a multitude of potential causes for spondylolisthesis. Some of these causes are preventable, such as is the case with injury, but others are unavoidable. (For example, consider birth defects). The precise cause of your spondylolisthesis is important, however, as it impacts the approach your doctor may use to treat the condition.
Spondylolisthesis: Diagnosis & Symptoms
When it comes to symptoms, spondylolisthesis can be a little weird. This is mainly due to the fact that a person may have had the condition since birth and not even know it. After all, minor cases of spondylolisthesis may not cause symptoms. Unfortunately, while this may a person’s current case, it is also extremely likely that he or she will develop symptoms during middle age.
So, what indications should you look out for? Generally speaking, it should raise your alarms if you notice the following:
- You have difficulty running or walking.
- You experience pain that originates in the back and travels down one of the lower extremities.
- There is a sharp pain in your lower back, or in some cases, your buttocks.
- One or occasionally both of the legs experience weakness.
- Painful symptoms are agitated when you move a certain way, such as twisting the torso.
- Noticeable lordosis (an inward curve of the spine) appears in the lower back.
Because of the fact that a person may not know if they have spondylolisthesis, there is a chance that the doctor will discover the condition during an unrelated exam. But what if the condition is expected? Well, usually doctors start with a physical examination and questionnaire. They will ask about your family history, what kind of symptoms you’ve been having, any medications that you currently take, and so on. If the physical examination suggests a spondylolisthesis diagnosis, there is a good chance that your doctor will order an X-ray to confirm his or her suspicions. From there, your doctor will be able to classify what form of the condition you may have.
Classifications of Spondylolisthesis
As we have already established, there are three major classifications of spondylolisthesis. The following sections will briefly touch upon these different determining factors.
In terms of causation, there are six classifications of spondylolisthesis:
- Dysplastic spondylolisthesis: A common form of the condition, present when congenital abnormalities exist within the upper sacral facets of the fifth lumbar vertebra.
- Degenerative spondylolisthesis: This form of the condition results from the natural wear-and-tear of the aging process. More specifically, facet joint arthritis often leads to this type of breakdown.
- Traumatic spondylolisthesis: This category is quite rare and occurs when there are acute fractures in the neural arch. (Note: this does not include fractures to the pars interarticularis, which we will learn more about shortly).
- Pathologic spondylolisthesis: Simply put, this form of the condition is caused by a severe viral or bacterial infection.
- Post-surgical spondylolisthesis: This form of spondylolisthesis results from complications that arise following a surgical procedure.
- Isthmic spondylolisthesis: This form of the condition occurs when there is an observable defect within the pars interarticularis.
In terms of severity, spondylolisthesis can be classified according to five grades. Doctors determine these grades based on the degree of slippage, which is measured as the percentage of the vertebral body’s width over the vertebra beneath it:
- Grade I: 0-25% (roughly 75% of all cases fall under this classification)
- Grade II: 25-50%
- Grade III: 50-75%
- Grade IV: 75-100%
- Grade V: The most severe grade, grade V indicates that the vertebra has slipped entirely off the spinal column (a greater than 100% degree of slippage). This form of the condition is exceedingly rare and doctors call it spondyloptosis.
With location classification, doctors determine spondylolisthesis based on which vertebrae are involved as well as which parts of the bone are affected. Most commonly, this form of classification is used to determine the three subtypes of isthmic spondylolisthesis (the most common form of the condition). These subtypes are as follows:
- Subtype A: pars interarticularis fatigue fracture
- Subtype B: pars interarticularis elongation as a product of multiple healed stress effects
- Subtype C: pars interarticularis acute fracture
Have you been experiencing symptoms for a period of two weeks or more? Have conservative methods such as over-the-counter medicines or special exercise regimens not proven to be effective? If so, you may want to consider giving Dr. Jason Lowenstein a call at (855) 220-5966. Dr. Lowenstein is a highly trained veteran in his field as well as a founding member of The Advanced Spine Center. Not only that, but he also serves as Morristown Medical Center’s Director of Spinal Deformity. When it comes to your back, there is no one whom you can trust more! For best results, contact Dr. Jason Lowenstein today!