What Is Lumbar Spondylolisthesis (Vertebral Slippage)?
Lumbar spondylolisthesis refers to the forward slippage of an upper vertebra over the vertebra beneath it. Age-related wear and tear is a common cause, and this usually involves the L4 vertebra slipping forward over L5. In many cases, lumbar spondylolisthesis is accompanied by “spinal stenosis” (narrowing of the spinal canal). It is most commonly seen in children and in middle-aged or older adults.
Symptoms
What Are the Symptoms of Lumbar Spondylolisthesis?
The main complaints in patients with lumbar spondylolisthesis are pain in the lower back and hips. The intensity of this pain tends to increase when bending forward and decrease when bending backward. These patients may also frequently experience low back pain while walking and may be forced to stop. Standing for long periods of time or having cramps in the legs in the evening can also be among the signs of vertebral slippage.
How Is Lumbar Spondylolisthesis Diagnosed?
In such situations, the most important step is to see a doctor. An incorrect intervention on the spine can lead to very serious consequences. During the examination, your doctor may request an MRI, or the diagnosis may be made using dynamic X-rays (taken while bending forward, backward, etc.). MRI performed in different positions can help determine whether there is slippage of a vertebra and, if so, to what degree.
What Are the Non-Surgical Treatment Methods for Lumbar Spondylolisthesis?
For patients diagnosed with lumbar spondylolisthesis, medical (conservative) treatment is usually tried before surgery. Here, the severity of the pain and the degree of vertebral slippage are important. Your doctor may ask you to reduce your daily activities. If necessary, a lumbar brace may be recommended. A brace can help reduce pain and relieve muscle spasm. Injections into the back, known as steroid injections, may also be used; however, these are not a definitive solution.
What Are the Physical Therapy Methods in Lumbar Spondylolisthesis?
Your doctor will prepare a rehabilitation program tailored for you, and through this program the muscles in your lower back will be strengthened. By stretching the short and tight muscles around the hips and lumbar region, the aim is to make the slipped vertebra more stable and better supported. During this period, you will need to be under regular medical supervision.
When Is Surgical Treatment Necessary in Lumbar Spondylolisthesis?
Depending on the severity of the slippage in the spine and the patient’s symptoms, your doctor may consider surgical intervention. It should be emphasized that surgery is generally recommended when pain and other complaints cannot be controlled with medical (non-surgical) treatment. Difficulty walking, functional problems in the bowel and bladder, and negative changes in the nervous system may also make surgery necessary.