What is Spondylolisthesis (a Slipped Disc)?
A slipped disc, also known as spondylolisthesis, is a condition that occurs when a bone in the lower spine shifts out of position and is displaced forward over the vertebrae (bone) beneath it. The condition can develop from spondylolysis, which is a stress fracture in one of the stacked bones (also called vertebrae) that make up the spinal column. Spondylolisthesis occurs when spondylolysis weakens the bone to the point that it begins to shift out of position in the spinal column. In addition with arthritis, the facet joints may become worn out and are no longer able to stabilize the vertebra which causes degenerative spondylolisthesis. If the bone shifts out of position too far, it may begin to press on surrounding nerves causing irritation or nerve damage that can cause shooting pain down the legs.
What Are the Symptoms of a Slipped Disc?
A slipped disc (spondylolisthesis) can cause a wide variety of symptoms. Some individuals may not experience any symptoms at all while others can experience mild to severe symptoms. These include lower back pain, tightness in the hamstring muscle, stiffness, tenderness surrounding the area of the slipped disc, and pain in the thighs and buttocks. A slipped disc may cause lordosis (called “swayback”) or kyphosis (called “roundback”) as the lower spine displaces from the upper spine. Some patients may develop symptoms from compression of the nerves.
What Are the Causes of Spondylolisthesis/Slipped Disc?
Spondylolisthesis can affect both children and adults. There are three common forms of spondylolisthesis:
- Degenerative spondylolisthesis
- Congenital spondylolisthesis: present at birth and is caused by abnormal bone formation
- Isthmic spondylolisthesis: develops from spondylolysis, which is a stress fracture in one of the vertebrae bones. In some cases, the fracture is so severe that it causes the bone to slip out of its position.
Three less common forms of spondylolisthesis include:
- Pathological spondylolisthesis: a disease, tumor or infection weakens the spine
- Traumatic spondylolisthesis: some form of trauma or injury causes the spine to fracture and move out of its position.
- Post-surgical spondylolisthesis: occurs when spinal surgery causes or worsens bone slippage.
What Are the Treatments for Spondylolisthesis/Slipped Disc?
Treatments for a slipped disc vary depending on the patient and overall severity of the condition. Dr. Shibayama may recommend non-surgical treatments such as stretching, modifying activity, abstaining from sports, taking anti-inflammatory medication to reduce pain, wearing a back brace, or undergoing physical therapy.
If a patient does not improve after non-surgical treatment and the vertebra continues to slip, Dr. Shibayama may suggest surgery as a solution for spondylolisthesis. The goal of the surgery is to relieve pain, stabilize the spinal bones that have slipped out of position, and improve the patient’s functionality. There are two primary kinds of surgery to treat spondylolisthesis/slipped disc:
- Lumbar laminectomy
- Lumbar fusion