What is SPONDYLOLISTHESIS?.

Spondylolisthesis occurs when a small break in a spinal bone allows the front part of the vertebra to separate and slip foward,literally a ‘broken’ or ‘fractured’ back.

About 7 in every 100 people have this defect in their back.It is commonly found in elite athletes (17 to 35%) and Eskimos (40%).Most are detected by chance-seen on x-rays taken for an unrelated problem.A few years ago any person whose x-rays showed this abnormality was treated as if they were fragile.Sport,physical work or military service was forbidden.

This advice was terribly wrong and some people were needlessly turned inti semi-invalids.In some cases the deformity is entirely symptomless.The fact is plain x-rays simply do not tell whether a person’s spine is mechanically sound.

What causes a spondylolisthesis?.

Spondylolisthesis can start from either under-development of the joints that guide the motion of the spine (facets),or a section of the bone at the back of the vertebra.This usually occurs in the low back region,mainly at the level of the fifth lumbar vertebra.The commonly accepted reason that a spondylolisthesis develops is thought to be stress fractures caused by childhood falls onto the bottom.

In the case of Eskimos,being carried upright in papooses as babies.These activities apply too much weight or force onto the immature spinal bones.

This type of spondylolisthesis is usually found in adolescent or young adult.Spondylolisthesis can be also due to osteoarthritic degenaration (wear and tear) of the Facet joints-this is often seen in people over the 50 years of age.

Quite often the first sign that a person may have an underlying problem is that they feel a deep,dull aching type pain,generally localised to to the low back.The person may complain of pain particularly after sitting or standing for prolonged periods of time.The person may also complain of general low back pain and possibly shooting sciatic pain down the buttock and or leg.On assessment of person with a spondylolisthesis, a ’step’ can quite often been seen or felt at the area of the spondylolisthesis.

The pain or discomfort felt by the person is relative to the degree of displacement of the vertebra. As it can be seen, the further displaced forward the vertebra becomes the more stress and strain is places on the surrounding structures.

It should also be noted that the pain does not come for spondylolsthesis itself,but rather from the stress placed on the structures around it (muscles,ligaments and joints),required to work more to hold the low back in it;s correct alignment.Occasionally if a spondylolsthesis progresses far enough it can affect the nerves in the area.

Treatment.

Is surgery or a special brace needed?.For the vast majority,certainly not! Chiropractic spinal adjustments are excellent for managing the mechanical problems that may come from the spondylolisthesis’ sway-back posture.

The key factors for a healthy working spine are strength,stability and flexibility.You cant measure those things on a plain x-rays.What you see on x-ray has to be related to what you find during a ‘hands on’chiropractic examination.

The best form of treatment for spondylolisthesis is through conservative mangement and monitoring via chropractic adjustments,soft tissue work and muscle strengthening excises to stabilise the area.In particular abdominal and spinal muscels should be strengthened as these are the core stabilising muscels of the spine.

Studies have shown that chiropractic therapy,when applied to patients with spondylolisthesis,resulted in 80% of patients having favourable outcomes and rapid symptomatic pain relief.

Your chiropractor will not adjust the segment that has slipped foward itself but will adjust areas around it to ensure proper joint function.

Curent medical treatment of spondylolisthesis consists of anti-inflammatory drugs and surgery.These are are quite invasive treatments and have also been shown to be less effective,have shorter lasting effects,and be riskier than consertvative chiropractic management.The medical treatment regime should only be viewed as a last resort if the spondylolisthesis is causing severe pain,neurological compromise or if it is progressing and slipping further.In all the collective years of practitioners in this practice,there has only been one case where a spondylolisthesis needed surgery.