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General Practice 2023

Spondylolisthesis: what é, symptoms, causes and treatment

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Spondylolisthesis: what é, symptoms, causes and treatment
Spondylolisthesis: what é, symptoms, causes and treatment

Spondylolisthesis is a condition that affects the spine and occurs when a spinal vertebra slips forward, causing the spine to become misaligned and causing compression of the nerves, leading to the appearance of symptoms such as persistent pain, stiff back or tingling of the legs.

This condition is most common in the lumbar spine, but it can also affect any part of the spine, such as the cervical region, and is usually caused by the natural aging of the body, causing the intervertebral discs to become dehydrated and more fine.

The diagnosis of spondylolisthesis is made by the orthopedist, who can indicate the most appropriate treatment, which can be done with the use of drugs, such as anti-inflammatory drugs or corticosteroids, to relieve pain, physiotherapy and, in some cases, surgery.

Symptoms of Spondylolisthesis

Spondylolisthesis may not cause symptoms, however, symptoms may arise when the change in the vertebra is severe, and varies with the region of the spine affected, the main ones being:

  • Lumbar pain that can radiate to the buttocks or legs, being characterized as sciatica;
  • Neck pain, which may radiate to the arms;
  • Difficulty walking or standing for long periods;
  • Difficulty coordinating movements or moving around;
  • Numbness or weakness in feet;
  • Tingling sensation in arms or legs;
  • Twitching in muscles behind thigh;
  • Muscle stiffness or back.

It is important to consult an orthopedist whenever symptoms of spondylolisthesis appear, so that the diagnosis can be made and the most appropriate treatment started.

How to confirm the diagnosis

The diagnosis of spondylolisthesis is made by the orthopedist through the evaluation of symptoms, he alth history, lifestyle habits, such as physical activity, and physical examination evaluating movements, muscle strength and whether there is any difficulty in walking or lift your legs, for example.

Also, the doctor may order imaging tests to check the position of the spinal vertebrae and confirm the diagnosis, such as X-ray, CT scan, MRI or PET-CT. Learn how PET-CT is made.

Possible causes

The most common cause of spondylolisthesis is the degeneration of the vertebrae, which occurs as a result of a natural aging process in the body, causing the intervertebral discs to lose water, become dehydrated and thinner, which can lead to the slippage of the vertebra forward.

However, there are other situations that can lead to spondylolisthesis, such as:

  • Congenital malformations of the spine, which arise from birth;
  • Blows or trauma to the spine, especially in traffic accidents;
  • Diseases of the spine or bones, such as osteoporosis or cancer;
  • Complication after surgery on the spine;
  • Practice of sports that cause stress or overload on the spine, such as gymnastics, football or weight lifting, for example.

Also, another condition that can cause spondylolisthesis is spondylolysis, characterized by a fracture or crack in a vertebra of the spine, resulting in the vertebra sliding forward or backward.

How the treatment is done

The treatment of spondylolisthesis varies with the intensity of the symptoms and the degree of displacement of the vertebra, and should be done with the guidance of an orthopedist who may indicate rest, use of medication, physical therapy or surgery.

The main treatments for spondylolisthesis include:

1. Rest

In the case of people who practice physical activities constantly, the doctor may recommend rest and avoid physical exercises, to avoid overloading the spine and worsening symptoms.

2. Use of medication

The drugs prescribed by the orthopedist for spondylolisthesis aim to reduce pain and discomfort in the spine.

The main drugs indicated are:

  • Anti-inflammatories, such as ibuprofen or naproxen;
  • Analgesics, such as paracetamol;
  • Opioids, such as tramadol.

Furthermore, there are other medications that may be indicated for spondylolisthesis such as corticosteroid injection, such as Dexa-citoneurin or Hydrocortisone, applied directly to the site of the displaced vertebra to quickly relieve pain and inflammation.

3. Physiotherapy

Physiotherapy sessions for spondylolisthesis may be indicated by the doctor to complement the treatment with medication, allowing to relieve pain more quickly and reducing the need for higher doses.

Physiotherapy should be performed under the guidance of a physical therapist, respecting the limitations of each person, and stretching exercises that increase flexibility and improve spine stability may be recommended.

In addition, exercises can be performed to strengthen the muscles of the back and abdominal muscles, which support the spine, which helps to decrease the movement of the vertebrae, reduce inflammation and, consequently, relieve pain. Find out how physiotherapy is performed for the spine.

Physiotherapeutic treatment can also include the use of pain relief devices, manual therapy techniques, lumbar stabilization exercises, stretching of the tibial hamstrings, located on the back of the legs.And RPG exercises, Clinical Pilates and Hydrokinesiotherapy, for example, can still be recommended.

4. Surgery

Surgery is indicated by the physician in cases where no other treatment option has been effective in controlling the pain of spondylolisthesis, or in cases where the displacement of the vertebra is severe and the displacement of the vertebra is compressing the nerves.

This surgery is done by the doctor to stabilize and align the spine, usually using a bone graft or metal rod. Physical therapy sessions are usually required after surgery to speed up recovery.

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