Low back pain can occur from several causes, one of which is called: spondylolisthesis. In 1854, the term was invented with Greek terms, “spondylo” for vertebrae and “olisthesis” for slip. These “slips” are most frequently found in the lower back (90 percent at L5 and 9 percent at L4). According to specialists, the most common form of spondylolisthesis is termed “isthmic spondylolisthesis,” and is a disorder that entails a defect in the back of the vertebra in a region called pars interarticularis, which is the portion of the vertebra that links the front half (vertebral body) to the back half (the posterior arch).
This may occur on one or both sides, with or without a forward slip or move, which is then called spondylolysis. Isthmic spondylolisthesis occurs in about 5-7 per cent of the general population, affecting men over women 3:1. Debate persists as to whether this happens as a result of genetic predisposition triggered by environmental conditions early in childhood, as demonstrated by an elevated prevalence in groups such as Eskimos (30-50 per cent), where young people typically carry papooses, loading their lower spine vertically at a very young age. However, isthmic spondylolisthesis may occur at any point of life if a substantial back bending force occurs, resulting in a fracture but reportedly occurring more often between the ages of 6 and 16 years.
Typically, traumatic isthmic spondylolisthesis occurs during teen years and is actually the most common source of low back pain at this point of life. Sports that most often cause this form of injury include gymnastics, weightlifting (from squats or dead lifts) and diving (from overarching the back). Excessive back bending is the force that overloads the back of the vertebra resulting in a fracture often referred to as a stress fracture, a fracture that happens as a result of repeated overloading over time, typically from weeks to months.
If the spondylolisthesis lesions are not healed by cartilage or bone replacement, the front half of the vertebra can slip or slide forward and become unstable. Luckily, most of these are recovering and being stable and not progressing. Diagnosis can be made by simple x-rays, but it is important to assess the degree of stability, “stress x-rays” or x-rays taken at the endpoints of bending back and forth. Often a bone scan is required to decide whether there are new injury verses and old isthmic spondylolisthesis.
Another very common form is called degenerative spondylolisthesis, which occurs in 30 per cent of Caucasian women and 60 per cent of African-American women (3:1 female to males). This typically occurs at L4 and is more prevalent in older females. It is often referred to as “pseudospondylolisthesis” because it does not contain defects in the posterior arc, but rather results from the degeneration of the disc and facet joints. As the disc space narrows, the vertebra slips forward. The problem here is that the spinal canal, where the spinal cord moves, is crimped or bent by the forward sliding vertebra and causes the spinal nerve root(s) to be squeezed, resulting in discomfort and/or numbness in one or both legs. The good news about spondylolisthesis is that non-surgical treatments, such as spinal manipulation in particular, work well and Osteopathy is a rational treatment approach!
If you are suffering from lower back pain or any issues you may need to seek treatment for, please book in to see us at this link now www.cramosteopaths.co.uk/book-online