Spondylolisthesis - Effective Treatments

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What is the treatment for spondylolisthesis? What type of surgery treats spondylolisthesis?

The initial treatment for spondylolisthesis is conservative and based on the symptoms.

  • A short period of rest or avoiding activities such as lifting and bending and athletics may help reduce symptoms.
  • Physical therapy can help to increase range of motion of the lumbar spine and hamstrings as well as strengthen the core abdominal muscles.
  • Anti-inflammatory medications can help reduce pain by decreasing the inflammation of the muscles and nerves.
  • Patients with pain, numbness, and tingling in the legs may benefit from an epidural steroid (cortisone) injection.
  • Patients with isthmic spondylolisthesis may benefit from a hyperextension brace. This extends the lumbar spine, bringing the two portions of the bone at the defect closer together, and may allow for healing to occur.
  • Home remedies for spondylolisthesis are similar to those for low back pain and include ice, heat, and over-the-counter analgesics such as acetaminophen (Tylenol) and anti-inflammatory medications.

For those whose symptoms fail to improve with conservative treatment, surgery may be an option. The type of surgery is based on the type of spondylolisthesis. Patients with isthmic spondylolisthesis may benefit from a repair of the defective portion of the vertebra, or a pars repair. If an MRI scan or PET scan shows that the bone is active at the site of the defect, it is more likely to heal with a pars repair. This involves removing any scar tissue from the defect and placing some bone graft in the area followed by placement of screws across the defect.

If there are symptoms in the legs, the surgery may include a decompression to create more room for the exiting nerve roots. This is often combined with a fusion that may be performed either with or without screws to hold the bone together. In some cases, the vertebrae are moved back to the normal position prior to performing the fusion, and in others the vertebrae are fused where they are after the slip. There is some increased risk of injury to the nerve with moving the vertebra back to the normal position. Outcomes and recovery after surgery are improved with physical therapy rehabilitation.

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See what others are saying

Comment from: achin back., 55-64 Male (Patient) Published: September 11

Taking medicine alone is not a cure for spondylolisthesis. They can be good but you also need to maintain your spine stability with pelvic tilt exercises and hamstring stretching. I lie on the floor with my legs up on the chair or couch several times a day to try to make my L5 return to a more normal position. I also sleep on my back with a pillow under my knees. If you don't do the right exercise and stretches your condition will get worse.

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Comment from: Slw11, Female (Patient) Published: February 15

I can so relate to everyone. I was diagnosed about 18 years ago with spondylolisthesis level one and now it a level 2 with degenerative disks and sciatica nerve pain. The depression is the worst! I hate all the medicines because they cause upset stomach, constipation and depression. I'm going to have the selective nerve block and I'm hoping that it works. Like a lot of you, I loved to run, bike, exercise and play with my grandchildren. A lot of that has stopped because every time I feel better, I want to do everything I did before and I end up hurt again. I also broke my neck at 16 but the doctors couldn't see it so I was misdiagnosed with muscular dystrophy due to the atrophy in my muscles for 18 years. If I don't keep pushing myself, I'm afraid I will just shut down. My mind wants to go but my body doesn't. I'm only 49 years old and feel like this is so ridiculous and that I'm too young for all this stuff. People really don't understand until they go through it. Thanks for letting me get this off my chest.

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