What are the other Names for this Condition? (Also known as/Synonyms)

• Lumbar Spondylolisthesis
• Spondylolisthesis of the Lumbar Spine

What is Adult Spondylolisthesis in the Lower Back? (Definition/Background Information)

• Spondylolisthesis is an extremely painful and traumatic injury that involves a vertebra in the spine, which slips forward out of its normal position, resulting in abnormal pressure on the nerve roots
• Adult Spondylolisthesis in the Lower Back is an extremely painful and traumatic injury that occurs when the lumbar spine (in the lower back) slips out of its normal position. It is also called Spondylolisthesis of the Lumbar Spine

There are many types of Spondylolisthesis condition. Some of the less common types are spinal slippages that result from a severe fracture or a tumor. However, three common types include Congenital, Degenerative, and Spondylolytic Spondylolisthesis.

Who gets Adult Spondylolisthesis in the Lower Back? (Age and Sex Distribution)

• Adult Spondylolisthesis in the Lower Back predominantly develops in ‘adolescent-adult’ males between 16-35 years old
• Individuals of both genders and all racial/ethnic groups, may develop this painful spinal disorder affecting the lower back
• The condition is less prevalent in women, in whom the signs and symptoms are typically milder. Hence, the condition is harder to identify among this group

What are the Risk Factors for Adult Spondylolisthesis in the Lower Back? (Predisposing Factors)

Common risk factors associated with Adult Spondylolisthesis in the Lower Back include:

• Rough or high-impact sports associated with athletics
• Abnormal inward curvature of part of the lumbar spine, termed as lordosis
• Postmenopausal women or inactive older individuals with a degenerative joint disease, such as osteoporosis
• Certain occupations that require excessive lifting of heavy objects
• Abnormal inflammation and damage to the cartilage that line the joints, such as due to osteoarthritis
• Traumatic injury to the spine caused by an automobile accident
• Poor posture
• Excess body weight associated with obesity, which can abnormally increase the pressure on joints
• Pregnant women
• Smoking can negatively affect vertebrae water level and rapidly increase the chances of disc degeneration

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Adult Spondylolisthesis in the Lower Back? (Etiology)

Some of the causes associated with Adult Spondylolisthesis in the Lower Back include:

• An advancing age
• Congenital lumbar spinal stenosis (an abnormally narrow spinal canal, which is present at birth)
• Traumatic spinal fracture
• Performing repetitive or highly stressful activities that are associated with athletics, or are occupation-related, which affect the vertebral bones

What are the Signs and Symptoms of Adult Spondylolisthesis in the Lower Back?

Signs and symptoms of Spondylolisthesis of the Lumbar Spine include:

• Excessive pain and stiffness within the lower back
• Feeling of weakness in the legs
• Tight hamstring muscle
• Numbness or a tingling sensation in the buttock or thighs
• Abnormal stiffness of the lower back
• Feeling of tenderness surrounding the site of the prolapsed (slipped forward) disc

How is Adult Spondylolisthesis in the Lower Back Diagnosed?

Diagnostic methods that a physician may use to help diagnose Adult Spondylolisthesis in the Lower Back include:

• Physical examination: The physician will perform a thorough physician examination to assess any pain or weakness. The patient may be asked to perform minor physical tasks or actions, like leaning forward/backward, etc. In addition to this, the individual’s medical history shall be evaluated
• X-rays: X-rays are useful in showing if the lumbar bone has slipped forward and the extent of the slippage. This diagnostic test may also show if any abnormalities due to advancing age are present within the spine, such as the formation of bone spurs
• Magnetic resonance imaging (MRI): An MRI is a more detailed scan that uses radio waves and a magnetic field to generate thorough images of interior bones and soft tissues. An MRI scan can take a clearer image of the prolapsed disc and identify any compression in the spinal cord (if any)
• Computerized tomography (CT): A CT scan takes a series of x-ray images from several different angles, which are then merged to create cross-sectional images of bones and soft tissues with the body. This allows a physician to examine the spinal column and its surrounding structures

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Adult Spondylolisthesis in the Lower Back?

Complications of Adult Spondylolisthesis in the Lower Back could include:

• Chronic pain
• Temporary or permanent injury to the spinal roots

How is Adult Spondylolisthesis in the Lower Back Treated?

The treatment associated with Adult Spondylolisthesis in the Lower Back, primarily focus on relieving symptoms that are causing the pain and stiffness. Non-invasive treatment measures include:

• Non-steroidal anti-inflammatory oral medications may be used to treat Adult Spondylolisthesis in the Lower Back. These medications can help decrease pain and swelling
• Corticosteroid injections into the epidural space (region near the spine, inside the vertebral column) help provide temporary relief of symptoms, and in improving the range of motion. It is important to note that corticosteroid injections only give temporary relief. Prolonged episodes of such injections, may injure the joints in the long-run
• Physical therapy exercises that include strengthening and improving flexibility of the lower back. Proper stretching of the lower back and abdominal muscles is also advised

Surgical treatment for Adult Spondylolisthesis of the Lower Back may be recommended, if an individual does not respond to conservative management of the condition. Individuals are advised to discuss alternatives with their physicians, before making a decision.

Common surgical procedures that involve decreasing compression of the spinal cord include:

• Lumbar laminectomy: This surgical procedure is intended to relieve pressure on the spinal cord and/or nerves by removing the lamina. During a lumbar laminectomy procedure, the lamina (small section of the bony roof in the spine) is removed to create additional space for the surrounding nerves within the spinal canal. A bone graft material then fills the empty space and two or more vertebrae of the lumbar spine are fused together to create stability. However, this procedure may also be performed, without a lumbar spinal fusion
• Anterior lumbar interbody fusion (ALIF): This surgical procedure is performed from the front through an abdominal incision. It involves the removal of damaged or diseased intervertebral bone and the surrounding lumbar discs. A bone graft material is then used to fill the empty space, and it is fused together with the lumbar spine

How can Adult Spondylolisthesis in the Lower Back be Prevented?

Adult Spondylolisthesis affecting the lower back is a condition that is very difficult to prevent, due to a variety of risk factors being involved. However, observing certain preventative guidelines may help decrease the risk of development of the condition. These include:

• Exercising regularly
• Adequate rest between exercises, can help prevent injuries due to overuse
• Individuals, who participate in any rough, high-impact sports (like football), should wear appropriate safety equipment to help decrease the risk of developing Adult Spondylolisthesis in the Lower Back
• Maintain a healthy body weight, which can help to reduce unwanted stress on the spine

What is the Prognosis of Adult Spondylolisthesis in the Lower Back? (Outcomes/Resolutions)

• The long term prognosis of Adult Spondylolisthesis in the Lower Back, depends on the severity of the condition
• In cases where the slipped vertebrae is not pressing on any nerves, an individual may not experience a recurrence of Spondylolisthesis, after treatment
• Generally, conservative treatment methods are usually successful in relieving symptoms for a high percentage of individuals, with mild Spondylolisthesis cases
• For a high percentage of individuals with severe cases of the disorder, surgical treatment may be successful in relieving the symptoms and providing a better quality of life

Additional and Relevant Useful Information for Adult Spondylolisthesis in the Lower Back:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/diseases-conditions/spinal-cord-injuries/