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Friday, December 27, 2013

Medical Media Images presents a Patient Information Article: Lumbar Spondylolisthesis (Abnormal Shift between the Low Back Vertebrae) - Part I

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                           Lumbar Spondylolisthesis
                     (Abnormal Shift between the Low Back Vertebrae)

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                    What does "Lumbar Spondylolisthesis" mean?

The word “Lumbar spondylolisthesis” is a combination of the Greek words “spondylos”, meaning “spine”, and “listhesis” meaning “slippage”. Altogether Lumbar Spondylolisthesis means a Slippage between the Vertebrae.
                               What is a Lumbar Spondylolisthesis?

One vertebra slips forward or backward on another. This slippage can cause nerve compression at that segment of the spine. Patients with this condition may experience a combination of back pain and leg pain.

Does the Spine shift back and forth in a Spondylolisthesis?

The condition of a spondylolisthesis can be divided into those which are stable versus unstable. In an unstable condition, the vertebrae can shift back and forth when the spine moves or with weight-bearing. Patients with an unstable Spondylolisthesis are more likely to have symptoms. Overall only a fraction of the patients who have a Lumbar Spondylolisthesis will be unstable.
What happens when the Vertebrae shift in a Spondylolisthesis?
When vertebrae shift on each other, several things can happen in the spine:
1.     The discs are stressed since they are attached at the top and bottom sides of the vertebrae which shift. This can cause low-back pain, or even a disc herniation.
2.     The facet joints in the back of the spine can be stressed and pulled apart. This can cause facet joint pain.
3.     The foramen through which the spinal nerve travels often gets smaller in a Lumbar Spondylolisthesis. This can trap the spinal nerve and cause leg pain (sciatica).
What are the different types of Lumbar Spondylolisthesis?
1.     Congenital Spondylolisthesis
These patients will be born with the condition. This condition is also called a “dysplastic spondylolisthesis”. Children are born with a spinal malformation which causes a shift between the vertebrae. This is a rare condition.
2.     Isthmic Spondylolisthesis
This type of spondylolisthesis occurs as a result of a spondylolysis (link) defect. This is the most common form of spondylolisthesis. It occurs in approximately 5-7% of the population.
3.     Degenerative Spondylolisthesis
This type develops as part of an advanced degenerative process of the spine. Typically, the facet joints on the back of the spine become arthritic and form large bone spurs. These bone spurs then begin to push the vertebra forward, causing the shift.
4.     Traumatic
Due to severe spine trauma. Part of the vertebra can be pushed forward due to the force on the spine.
5.     Pathological
Due to a spine cancer which weakens the vertebra.
How is the Severity of a Lumbar Spondylolisthesis determined?

The severity of a Spondylolisthesis is determined by the amount of slippage between the vertebrae (Meyerding grading system):
Grade I: The shift is 0-25% of one vertebra on another
Grade II: The shift is 25-50% of one vertebra on another
Grade III: The shift is 50-75% of one vertebra on another
Grade IV: The shift is 75%-100% of one vertebra on another
A slippage of over 100% means that one vertebra is now completely in front of another. This condition has its own name, spondyloptosis.
              Stay tuned for Part - II of our Patient Education series on Lumbar Spondylolisthesis 


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