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: AccidentProne, 25-34 Male (Patient) Published: May 11

When I was 21 I was in a motorcycle accident, most everything was apparently ok. Five years after my accident my back started hurting terribly. I called out sick for a day at work, but pain was manageable so I stayed home. Next day pain was still present but I decided to go to work anyway, and had a huge safety violation because I was distracted by pain. I called out sick again the next day and went to the hospital. I had to beg for an MRI, waited 6 hours to get it. I was misdiagnosed with a herniated disc from the emergency room. When I followed up with a specialist who confirmed it was spondylolisthesis. Drugs made it bearable but still painful. I ran out of drugs and could not get a physician to refill me a prescription. Finally I followed up with a neurologist as well for a second opinion. My neurologist prescribed me gabapentin 300 mg three times a day. After 1 month the drug really took effect and I barely felt any pain. Just a thought for you guys for pain management. Gabapentin has some side effects that rarely happen. I've lost motor functions or coordination for small amounts of time so please be careful. Honestly though, between the side effects and the pain I choose the side effects.

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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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