Is a bone in your spine slipping? Let's talk about Spondylolisthesis!

Do you often have back pain? Does it hurt when you stand or walk for a long time? Does it sometimes feel like the pain is going down your legs? There are many reasons for this, but there may be a reason behind it that you don't think about. It is when one of the bones in your back, a vertebra, has slipped or slipped slightly from where it should be. In medicine, we call this condition Spondylolisthesis . Although the name may sound a bit strange, this is an important topic that we need to talk about and understand.

Simply put, what is Spondylolisthesis?

Think of your spine as a row of bricks stacked one on top of the other. Each of these bricks is called a vertebra . There are about 33 of these vertebrae in our spine. Although they are connected to each other, they can move a little when we walk, bend, and move our bodies.

Now, in the case of spondylolisthesis, one of the bricks in this row, that is, one vertebra, slips a little further than it should be, putting pressure on the vertebra below it. It's like one brick in a row of bricks sticking out a little. When it slips like this, the nerves around it can be compressed. That's when symptoms like back pain and pain that goes down the legs appear.

Although this condition can occur anywhere in the spine, it is most commonly seen in the lower part of our spine, that is, the lumbar spine . It can also sometimes occur in the neck (cervical spine) and upper part of the spine (thoracic spine).

What are the main types of Spondylolisthesis?

Spondylolisthesis can be divided into several main types depending on how it occurs. Let's take a look at what they are.

How do you know if you have this condition? What are the symptoms?

It's amazing how some people have spondylolisthesis and never experience any symptoms . If the amount of slipped vertebrae is very small (low-grade), it may not put much pressure on the nerves, so you may not feel any pain.

However, if symptoms do occur, they may be like this:

• Lower back pain: This is the main and most common symptom.
• Sciatica: This is a feeling of pain, numbness, or burning that radiates down the leg. It is caused by a slipped vertebra pressing on the sciatic nerve.
• Back stiffness: Feeling stiff in the back when you wake up in the morning or after sitting for a while.
• Difficulty walking or standing: Pain that seems to increase when standing or walking for more than a few minutes.
• Numbness, weakness, or a tingling sensation in the soles of the feet .

The location of the pain may vary depending on the location of the slipped vertebra. Sometimes the pain may spread to the buttocks or thighs.

Why do vertebrae slip like this? What are the risk factors?

Let's take a look at the causes of a slipped vertebra and who is most at risk for it.

Main reasons:

• Aging: The main cause is the wear and tear of the discs in the spine with age.
• Some people are born with thin vertebrae: This makes them more likely to fracture.
• Sports injuries: This risk is especially high for those who play sports that put a lot of pressure or strain on the back (e.g. gymnastics, weightlifting, fast bowling in cricket).
• Growth spurts in children: These conditions can occur due to the rapid growth of bones during periods when children and young adults suddenly gain height.
• Accidents: Back injuries caused by things like falls and car accidents.

Who is at higher risk?

• For people over 50 years of age (especially the degenerative type).
• For women.
• For athletes (especially those who play sports that involve bending their backs frequently and jumping).
• For those with a family history of this condition or bone-related diseases.

How to accurately determine this situation?

If you have these symptoms, the first thing you should do is see a doctor . The doctor will ask you questions and examine your back.

You should tell your doctor about when the pain started, what kinds of things you do that make the pain worse, and whether you were in any accidents before these symptoms appeared.

After that, the doctor will recommend several tests to confirm the disease:

• A back X-ray: This can be used to see if a vertebra has slipped and how much it is slipping.
• CT scan (Computed Tomography scan): This can provide a clearer picture of the structure of the bones.
• MRI (Magnetic Resonance Imaging) scan: This can best check for damage to the discs and nerves between the vertebrae.

Degree of spinal stenosis (Grades)

After the X-ray, the doctor will classify your vertebrae into a grade based on how much they are slouched.

• Low-grade (Grade I and Grade II): This means there is a small amount of slippage. Most people have this level. This usually does not require surgery.
• High-grade (Grade III and Grade IV): This means that there is a significant amount of slippage. In these cases, surgery may be necessary, especially if the pain is severe.

What are the treatments for this?

Many people with spondylolisthesis can manage their symptoms well with nonsurgical treatments.

When is surgery necessary?

Not everyone with spondylolisthesis needs surgery. Especially if it is a low-grade condition, and the symptoms are not severe, you may be able to live without surgery.

However, in these cases, your doctor may suggest considering surgery:

• If you have high-grade spondylolisthesis.
• If the pain is so severe that you can't stand or walk.
• If symptoms do not improve despite other treatments (non-surgical).

Surgery usually involves a procedure called spinal fusion . This involves fusing the slipped vertebra and the vertebra below it together to form a single bone. This gives the area more strength and stability. You may also need to have a surgery called spinal decompression to relieve pressure on the nerves.

What do you need to know when living with this condition?

Once you've been diagnosed with spondylolisthesis, your symptoms should improve within a few weeks or months with treatments such as rest, medication, and physical therapy. But remember, these treatments are only meant to reduce pain and help you function normally, not to put the slipped vertebra back in place. Only surgery can put the slipped vertebra back in place.

If you are an athlete, you may need to take a break from sports until you can move safely without pain. Be sure to talk to your doctor before you start playing again.

When do you want to see the doctor?

If you have back pain that lasts more than a few days, or is severe enough to interfere with your daily activities, see a doctor as soon as possible. The sooner the condition is diagnosed, the easier it is to treat and cure.

When to go to the Emergency Treatment Unit (ETU):

• If you have had an accident , such as a fall or a car accident.
• If you lose feeling in your legs or have difficulty controlling your urine or stool , go to a hospital's Emergency Department (ETU) immediately. These are very serious emergencies.

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