Spondylolisthesis and Spondylolsis Diagnosis & Treatment
In order to diagnose spondylolysis and spondylolisthesis, the doctor needs to examine x-rays of a portion of the lumbar spine that joins together the upper and lower joints. If there are cracks or fractures, the patient has spondylolysis. An x-ray of the lower back can confirm this abnormality.
If the fracture gap at the pars widens and the vertebra shifts forward, then the patient has spondylolisthesis. An x-ray will usually show the fifth lumbar vertebra shifting forward on the part of the pelvic bone called the sacrum. The doctor measures standing lateral spine x-rays to determine the exact amount of forward slippage. If the vertebra is pressing on nerves, the doctor usually recommends a CT scan or MRI before treatment begins to further assess the abnormality.
Nonsurgical Spondylolisthesis Treatment
For patients in pain from spondylolysis and spondylolisthesis, we may recommend taking a break from the activities aggravating the condition until symptoms go away, as they frequently do. Anti-inflammatory medications, and if necessary, steroid-anesthetic injections and nerve root blocks, may help reduce back pain.
Occasionally, a back brace and physical therapy are recommended. In most cases, activities can be resumed gradually and there will be few complications or recurrences. Stretching and strengthening exercises for the back and abdominal muscles can help prevent future recurrences of pain. Following up with periodic x-rays will show whether the vertebral position is changing position.
Surgery may be called for if the vertebral slippage becomes severe or if back pain does not respond to nonsurgical treatment and begins to interfere with daily activities. In that case, a spinal fusion is performed.