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What is a slipped back (spondylolisthesis)?
Spondylolisthesis is a condition in which one vertebra in the spine is displaced forward or backward relative to the other. It usually occurs in the lumbar region and can lead to nerve compression, low back pain and restricted movement.
Causes
- Congenital: A congenital condition caused by abnormalities in the development of the spine.
- Degenerative: It develops as a result of weakening of the disc and connective tissues due to aging.
- Traumatic: Slipping of the vertebrae as a result of accidents, falls or sudden strains.
- Isthmic: Fracture of the joints between the vertebrae (pars interarticularis).
- Pathologic: Weakening of the spinal structure due to tumors or infections.
Spondylolisthesis Grading
A slipped back is graded according to the degree of slippage:
- Grade 1: 0-25% slip (slight),
- Grade 2: 26-50% slippage (moderate),
- Grade 3: 51-75% slip (forward),
- Grade 4: 76-100% slippage (severe).
The degree of slippage is an important factor in the choice of treatment modalities.
Symptoms
- Back and leg pain
- Numbness or tingling in the legs
- Movement limitation
- Muscle weakness
- Increased pain after prolonged standing or walking
Diagnostic Methods:
- X-ray: Used to determine the degree of vertebral slippage.
- Magnetic Resonance (MRI): Shows whether there is nerve compression.
- Computed Tomography (CT): Bone structures can be examined in detail.
Treatment Methods:
1. Conservative (Non-Surgical) Treatment:
- Physical therapy and exercise: Strengthening the spinal muscles can prevent the progression of slippage.
- Painkillers and muscle relaxants: Provides temporary relief.
- Lumbar corset: Can reduce pain by supporting the spine.
- Epidural steroid injections: May relieve pain due to nerve compression.
2. Surgical Treatment:
- Spinal fusion (fixation of the spine): Fixation of slipped vertebrae with plates and screws.
- Laminectomy: Removal of part of a vertebra to relieve nerve compression.
- Dynamic stabilization: Using implants that support the spine while preserving movement.
Treatment depends on the age of the patient, the degree of slippage and the severity of the symptoms. In mild cases, physical therapy and exercise may be sufficient, while in severe cases surgery may be required.
