Surgery for degenerative spondylolisthesis is considered absolute only when there is an acute neurologic deficit (significant leg weakness). Typically when there is forward slippage of one vertebra on another there is minimal affect on the nerves. Unfortunately as the slip progresses it can pull on the nerves exiting the spinal canal causing pain, numbness and/or weakness. At this time, consideration should be given to surgery. Otherwise surgery is indicated if the pain continues to progress after all methods of non-operative therapy have been exhausted.
Surgical treatment for degenerative spondylolisthesis requires fusing the slipped vertebrae to the adjacent vertebrae. This will prevent the instability that causes pain. There are many ways that a surgeon can perform a fusion. One method is to take bone from the pelvis (autograft) and place it between the slipped vertebrae. Over time this bone grows in between the two vertebrae and fuses the two bones together, preventing the painful motion. There are reports that have indicated that a fusion is more likely to be successful if instrumentation is added to the procedure. This typically involves placing screws into the pedicles of the spine. The screws are connected by metal rods that hold the adjacent vertebrae together. The screws provide additional support to the spine while the fusion occurs. If spinal stenosis co-exists with the degenerative spondylolisthesis then a decompressive procedure (lumbar laminectomy) may also be performed.
For most cases of degenerative spondylolisthesis, treatment consists of temporary bed rest, restriction of the activities that caused the onset of symptoms, pain/ anti-inflammatory medications, steroid-anesthetic injections, physical therapy and/or spinal bracing.
Back Pain: Spondylosis, Spondylolysis, and Spondylolisthesis
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Failed back syndrome, or lumbar post-laminectomy syndrome, is the term given to patients who have had back surgery for back pain, but continue to have pain after surgery.
Fortunately there is non-surgical, non-narcotic treatment for patients with post-surgical neck or back pain.
Posted in Back Pain, Pain, Platelet Rich Plasma and tagged Back Pain, Back Pain Doctors, Back Pain Specialist, joint pain, Platelet Rich Plasma, Sarasota Neurology, Surgery by Dan Kassicieh, D.O.
Spondylolisthesis Definition, Causes, Symptoms and …
Mild cases of spondylolysis and spondylolisthesis usually cause minimal pain. In fact, the conditions are often found by accident when a person has a pre-employment exam or an X-ray of the back for an unrelated reason.
Spondylolisthesis is the displacement of a vertebra, ..
Treatment for a degenerative spondylolisthesis is based on the characteristics of the patient’s symptoms. Acute symptoms may sometimes be relieved with 1-2 days of bedrest. In addition, medications such as anti-inflammatories or narcotics can be given to help alleviate some symptoms.
Braces have a minor role in treatment as they can help stabilize the spine. This could be worn for comfort as needed, for a short period of time. Physical therapy is often prescribed to increase back conditioning. Typically when a patient has degenerative spondylolisthesis the muscles in the back have become deconditioned. Muscle strengthening can help by reducing the frequency and intensity of the spasms that occur with degenerative spondylolisthesis. There is also a role for epidural steroid injections to help alleviate any inflammation that may exist.
Spondylolisthesis Causes, Symptoms & Treatments | …
When spondylolysis and spondylolisthesis do cause pain, you may experience low back pain, stiffness, and muscle spasms. You may also have sciatica (pain radiating down one or both legs), or numbness, though this is not common. Leg pain will usually be worse when you stand or walk.
Isthmic spondylolisthesis is a further ..
Some people with spondylolisthesis are symptom free and only discover the disorder when seeing a doctor for another health problem. However, the forward slip of the vertebral body in severe cases of degenerative spondylolisthesis often leads to spinal stenosis, nerve compression, pain and neurological injury.