Spondylolisthesis

Spondylolisthesis occurs when one vertebra slips over another, which can cause pain, instability, and nerve damage.

Signs and symptoms

It may present one or more of the
following:
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  • Low back pain
    o cervical
  • Stiffness
    in the back
  • Pain that
    radiates
    down the legs
  • Weakness or
    numbness
  • Causes of spondylolisthesis
    • Degenerative spondylolisthesis is more common in people over 40 years of age.
      Degenerative spondylolisthesis is more common in women than in men.

      Dysplastic spondylolisthesis (vertebral deformity) is more common in children and adolescents.
      There are 5 categories of spondylolisthesis according to the cause of the disease:

      Degenerative (Natural wear and tear of the disc and the facets that allow displacement).

      Isthmic (When the bone at the back of the vertebrae that joins the vertebrae breaks).

      Post-traumatic or after accidents.
      Congenitally, they are born with a deformity called "dysplasia" in the last 2 vertebrae of the lumbar spine; this deformity allows one vertebra to shift over the other.
      Generalized bone pathology that degenerates and destroys the posterior elements (e.g., rheumatoid arthritis).

      There are other, less common types of scoliosis that may accompany the following problems:

      Cerebral palsy or muscular dystrophy.
      Defects in the formation of vertebral bodies during gestation
      Surgical interventions in the thorax in patients under 10 years of age
      Disc and/or vertebra infections.

      Vertebral tumors.
      Spinal cord abnormalities such as spina bifida occulta, myelomeningocele.

      Secundario a un síndrome genético como neurofibromatosis, mucopolisacáridos, artrogriposis, VACTER, entre otros.
  • Types of spondylolisthesis
    • 1. Congenital (dysplastic) spondylolisthesis
      2. Isthmic spondylolisthesis
      3. Degenerative spondylolisthesis
      4. Traumatic spondylolisthesis 5. 5. Pathological spondylolisthesis.
      6. Post-surgical spondylolisthesis
  • Risk factors
    • Anatomical and genetic factors.
      Physical and activity factors
      Degenerative factors
      Lifestyle factors
      Traumatic and medical factors
  • Complications
    • Difficult-to-manage sciatic pain in the leg. Chronic paraparesis or weakness in the legs. Atrophy of the leg muscles. Severe weakness and limitation in walking. Limitation in trunk flexion. Impaired bowel and bladder control.
  • When to consult a specialist
    • Most cases of spondylolisthesis in their early stages cause mild, self-limiting symptoms that improve with pain medication, typically lower back pain and occasional leg cramps. As the disease progresses, back pain increases and leg cramps become more frequent and intense. In advanced or severe stages, the disease causes constant back pain, difficulty walking, impaired bowel and bladder control, and severe leg cramps.

      La valoración debe realizarse en cualquier fase de la enfermedad, esto no significa que requieran cirugía, se realiza un manejo gradual que inicia con terapia física, analgésicos, bloqueos en columna, y en las fases avanzadas o cuando los síntomas no se controlan con los tratamiento previamente mencionados se interviene quirúrgicamente.

      Permíteme valorar el tipo y grado de tu espondilolistesis que tienes para guiarte en el mejor manejo para esta enfermedad.

    • Specialist in spinal pathologies

    Each case requires

    a different approach.

    Not all back pain requires surgery. The first step is a specialist evaluation to identify the source of the problem and determine the most appropriate treatment for each patient.