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.
Spondylolisthesis (spon-di-low-list-e-sis); is the forward or backward displacement of one vertebra over another. Spondylolisthesis can be seen throughout the entire spine, but is typically found within the (low back) region of the spine. A spondylolisthesis can be degenerative, traumatic or congenital in origin.
Spondylolisthesis Surgery in New York | WCM Center …
In each spinal vertebra there are 2 joints composed of inferior and superior articular processes. These are called facet joints and are the main articulations between adjacent vertebrae. The facet joints are held in place by fibrous tissue called capsules. As part of the normal degenerative process, the facet capsules become thin and weakened. This results in a stretching of the capsule and a sliding of one vertebra on another. This sliding of one vertebra on another is called spondylolisthesis. As a result of this sliding, there is instability in the joint and the body responds via a thickening (hypertrophy) of the facets. This hypertrophy can sometimes compress the structures adjacent to the bony facets, such as the nerves or spinal canal. This results in spinal stenosis (pressure on the nerves in the low back). Spinal stenosis is commonly seen with degenerative spondylolisthesis and is a cause for the many symptoms seen with this disease.
Degenerative Spondylolisthesis Treatment & Surgery | …
There are many new surgical techniques that are being developed to improve the results of lumbar fusions. Minimally invasive spine surgery for lumbar fusion is one of these newer techniques. MIS procedures have smaller incisions, cause less trauma to the surrounding normal tissues, and hopefully results in a faster recovery for the patient. One of these MIS techniques is a procedure known as extreme-lateral lumbar interbody fusion (XLIF). During the XLIF procedure the lumbar spine is approached from the side through a small skin incision. The surgery is performed through a muscle that lies next to the lumbar spine known as the psoas muscle.
Spondylolisthesis Treatment New York | Disc …
Spondylolysis (spon-dee-low-lye-sis) and spondylolisthesis (spon-dee-low-lis-thee-sis) are separate, yet related conditions. Spondylolysis usually comes first, though not always. The term comes from "spondylo," which means "spine," and "lysis," which means to divide. Spondylolysis is a breakdown or fracture of the narrow bridge between the upper and lower facets, called the pars interarticularis. It can occur on one side (unilateral) or both sides (bilateral) and at any level of the spine, but most often at the fourth or fifth lumbar vertebra (Fig. 2). If spondylolysis is present, then you have the potential to develop spondylolisthesis.
Spondylolisthesis Treatment - News Medical
Spondylolisthesis is the actual slipping forward of the vertebral body (the term "listhesis" means "to slip forward") (Fig. 3). It occurs when the pars interarticularis separates and allows the vertebral body to move forward out of position causing pinched nerves and pain. Spondylolisthesis usually occurs between the fourth and fifth lumber vertebra or at the last lumbar vertebra and the sacrum. This is where your spine curves into its most pronounced "S" shape and where the stress is heaviest.