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: cgholtz, 45-54 Female (Patient) Published: May 30

I had surgery for my spondylolisthesis on March 24. Immediately I could walk normal again but I am still very stiff and in some pain. I am glad I got the surgery but I wonder how long these symptoms will last.

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Comment from: In pain in Texas, 45-54 Female (Patient) Published: June 02

I originally had back surgery back in 2008. It did not go well, and I had the rod and screws put in and fusion done, but the doctor has since then lost his surgery privileges apparently. I am left with pain in my middle back as the disc just above the rod and the disc just below the rod are now degenerated. It is very depressing, plus about 3 years ago, I started having osteoarthritis in my hips as well. I am in pain a lot and often cannot get up unassisted from a chair. I am trying to lose weight, but it is very hard when you cannot move without some sort of pain in your back or hips. I understand how much each of you feels your pain; I go through the same thing, being depressed and trying to stay positive. I have degenerative disc disease and spondylolisthesis, but the last doctor said it wasn"t very bad. He obviously does not have pain every day like me and all the others. I am concerned that as I age, I will be unable to walk or stand because my back does not feel strong enough to hold me up sometimes. I have numbness and sciatica in my legs. I wanted to try the laser treatments, but apparently the surgical group does not take my insurance.

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