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Spondylolisthesis

Spondylolisthesis is a condition in which one vertebra slips forward on the one below it. In children, spondylolisthesis may occur as the result of a birth defect that affects the back of the spine or be caused by stress fractures within the back part of the spine. Spondylolisthesis is the most common cause of low back pain in adolescent athletes. In older people, the most common cause is degeneration of the discs between the vertebrae. With aging, the discs lose moisture, dry out and flatten, bringing the bones on either side closer together to the point where one slips forward on the other.

Typical symptoms of spondylolisthesis include pain across the lower back and legs, which occurs when the slipped vertebra irritates the nerves around it. However, a person can have the condition and not have pain.

A number of test may be used to aid in the diagnosis of spondylolisthesis and to locate the affected bone, including:

  • X-ray — High-energy radiation is used to take pictures of the spine.
  • Magnetic Resonance Imaging (MRI) — An MRI provides detailed pictures of the spine that are produced with a powerful magnet linked to a computer.
  • Computed Tomography (CT) Scan — A CT scan uses a thin X-ray beam that rotates around the spine area. A computer processes data to construct a three-dimensional, cross-sectional image.

Most often, treatment for spondylolisthesis includes:

  • Physical therapy to strengthen the back muscles
  • Pain medication
  • Bed rest
  • Wearing a back brace or corset

Children and adolescents whose spines have slippage greater than 30 percent to 50 percent may be candidates for spinal fusion surgery. Children and adults who have persistent pain despite non-operative care also may be considered for surgery.

Surgery for spondylolisthesis may involve decompression of the nerve roots by removing bone and/or intervertebral disc material, followed by fusion of the vertebrae with or without bracing.

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