Spondylolisthesis - Causes

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What causes spondylolisthesis?

There are five major types of lumbar spondylolisthesis.

  1. Dysplastic spondylolisthesis: Dysplastic spondylolisthesis is caused by a defect in the formation of part of the vertebra called the facet that allows it to slip forward. This is a condition that a patient is born with (congenital).
  2. Isthmic spondylolisthesis: In Isthmic spondylolisthesis, there is a defect in a portion of the vertebra called the pars interarticularis. If there is a defect without a slip, the condition is called spondylolysis. Isthmic spondylolisthesis can be caused by repetitive trauma and is more common in athletes exposed to hyperextension motions, including gymnasts and football linemen.
  3. Degenerative spondylolisthesis: Degenerative spondylolisthesis occurs due to arthritic changes in the joints of the vertebrae due to cartilage degeneration. Degenerative spondylolisthesis is more common in older patients.
  4. Traumatic spondylolisthesis: Traumatic spondylolisthesis is due to direct trauma or injury to the vertebrae. This can be caused by a fracture of the pedicle, lamina, or facet joints that allows the front portion of the vertebra to slip forward with respect to the back portion of the vertebra.
  5. Pathologic spondylolisthesis: Pathologic spondylolisthesis is caused by a defect in the bone caused by abnormal bone, such as from a tumor.
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Comment from: DOUG, 45-54 Male (Patient) Published: June 12

When I was 19 (1979) I was in the best shape of my life, a brown belt in Shorin-Ryu karate, when a body-builder got me involved in weight lifting. On day I arched as I bench pressed 225 lb. when I felt something happen to my lower back. When I went to get up off the bench I fell to the ground with a numb left leg. I was diagnosed with a grade II L5 -S1 spondylolisthesis. I have suffered severe nerve pain ever since and can't stand the pain medications so I have been overusing alcohol for past 15 years, although I seem to be able to go days without drinking as long as I ice my back after work. I've been terrified to have the surgery but my L5 has slipped to grade III. I have seen numerous surgeons but always back out last minute. I think I may just take the leap of faith and get the fusion before I can't walk. It's a very tough decision but at 54 years old I may be at the point of no return.

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Comment from: JDerek, 35-44 Male (Patient) Published: January 14

I joined the Army at the end of 1996 at the age of 24. On my 12th jump in 1998 I had a one in a million malfunction. After being taken to the hospital and all the x-rays they told me I had broken the facet on my L-5 vertebra and had subsequently acquired spondylolisthesis. They gave me some Airborne candy and sent me back to work. Six months, 3 more airborne operations and a 20K later I couldn't stand up straight. More x-rays and I was told I had broken the other facet on the tight and my airborne days and career were over. It took them 2 years to get through the process of medically discharging me during which time I was evaluated by an orthopedist. I was informed that I ran a high risk of being paralyzed from the waist down because both facets had been totally obliterated and there was nothing holding my spine to my pelvis. After the surgery, I pushed my physiotherapy and myself in an attempt to meet the minimum standards that would allow me to remain on active duty. It worked until 2007. During my second deployment the daily pain that I dealt with was getting to the point of being unmanageable without stronger medication which would impair my ability to do my job. At which point I was medically discharged. The pain hasn't gone away. It's a constant reminder. By the time I had the fusion done I had contracted lumbar spinal stenosis as an MRI revealed in 2009. The disk between my L-5 and S-1 wasn't removed before the fusion and sits dangerously close to my spinal column. This causes all sorts of weird sensations in my lower extremities not to mention loss of strength. Add in the added instability of my mid and upper back and I have interesting issues going both ways.

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