The Greek term for slipping of the spine is Spondylolisthesis. This term refers to the abnormal forward movement of one vertebra over the one below. It is in the lumbar spine that this forward slip of the vertebra happens most often. Pressure on the nerve roots associated with the affected vertebrae, as well as pain and dysfunction are caused by the slippage and herniation of the disc. The types of spondylolisthesis include:
Type 1 - Congenital spondylolisthesis
Congenital spondylolisthesis is a condition where a person is born with the abnormality of the posterior bony arch of the spine, which causes the slippage. It happens at the L5-S1 level commonly and is associated with abnormality of the facet joints. Symptoms include back pain during the adolescent growth spurt. CT and MRI scans are required to diagnose the dysplasia (abnormal bone formation).
Type 2 - Isthmic spondylolisthesis
Isthmic spondylolisthesis is a defect in a part of the bone called the pars interarticularis. This bone connects the upper joint of one vertebra to the lower joint. Stress fracture in individuals with a hereditary predisposition (some minor abnormality or weakness of the pars at birth) usually causes this. Sometimes a defect may exist without any forward slip, and this is called spondylolysis. This can also be painful.
Type 3 - Degenerative spondylolisthesis
Forward slippage secondary to arthritis of the spine is known as Degenerative spondylolisthesis. This process is usually also associated with Spinal stenosis. Long standing degenerative disc disease, leading to weak facet joints in the back of the spine is the reason. This is usually seen at L4-L5 level. This is also called Lumbar Spondylolisthesis.
For all the above conditions , surgery is indicated, if the slippage progressively worsens or if back pain does not respond to nonsurgical treatment and begins to interfere with daily life. In the congenital and high dysplastic group, spondylolisthesis surgery is done at early stages to prevent neurological complications.