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By Patrick Foote
There are a number of spondylolisthesis causes, including injury, repeated stress, genetic predisposition, and pathological issues. The normal degenerative processes that take place within the spine can also cause the condition, which occurs when one vertebra slips forward onto the vertebra below it. It is helpful to have a basic knowledge of the spinal anatomy to fully understand how degenerative spondylolisthesis can develop.
Spinal Anatomy
The spine is a highly complex network of vertebrae, intervertebral discs, facet joints, muscles, ligaments, and neural structures. Thirty-three articulating and fused vertebrae are the building blocks of the spine and are stacked atop one another. The articulating vertebrae are joined together by facet joints and are further connected by supportive muscles and ligaments. Together, these components form the spinal column, which protects the spinal cord and nerve roots, provides support to the upper body, and facilitates a wide array of directional movements. Since the spinal structures are closely interrelated, spinal degeneration in one component typically sets off a chain reaction within the network.
Understanding Degenerative Changes
Spinal degeneration can begin when the water-saturated, collagen- and protein-based intervertebral discs begin to dehydrate. The loss of water causes the normally pliable discs to become brittle and weak. If the structural integrity of a discs outer wall, or annulus fibrosus, is weakened, the inner core, or nucleus pulposus, can shift inside the disc and push against the wall. Abnormal disc bulge or even a rupture can occur as a result. Additionally, the bending, twisting, and turning motions that the spine performs daily usually causes normal wear and tear within the spinal structures, particularly the facet joints. Degenerative changes to the discs and facet joints may mean that a spinal segment can no longer maintain its proper position in the spinal column, and a vertebra may slip out of place. Most instances of spondylolisthesis occur in the lower back, or lumbar spine, as this area experiences a high level of wear and tear.
Additional Spondylolisthesis Causes
In addition to degenerative changes in the spine, vertebral slippage can also occur as a result of:
Stress injuries Individuals who have sustained repetitive stresses on the spine may be more susceptible to vertebral slippage. Football players, gymnasts, and wrestlers are particularly prone to developing this type of spondylolisthesis.
Genetics If spinal conditions run in an individuals family, the chance for experiencing vertebral slippage is higher. Additionally, people born with vertebral abnormalities run the risk for spinal misalignment.
Bone diseases or infections While rare, some pathological issues can lead to vertebral fracture and slippage.
Traumatic injuries A car accident or fall can generate enough force to suddenly displace one or more vertebrae.
Associated Symptoms
Lumbar spondylolisthesis causes a wide array of symptoms, including pain in the lower back, thighs, and/or buttocks, stiffness, muscle spasms, and reduced range of motion. If a displaced vertebra comes into contact with the spinal cord or a nerve root, additional symptoms of pain, numbness, tingling, and muscle weakness may radiate through the hips, buttocks, legs, and feet. A patient might physically exhibit a waddle-like gait, abnormal inward curvature of the lumbar region, and a protruding abdomen.
For the majority of patients, a regimen of conservative (nonsurgical) treatments can effectively alleviate symptoms. Surgical procedures are reserved for patients who do not respond to several weeks or months of conservative treatment or those who require immediate spinal realignment due to severe symptoms and/or a traumatic injury.
About the Author: Patrick Foote is the Director of eBusiness at Laser Spine Institute, the leader in endoscopic spine surgery. Laser Spine Institute specializes in safe and effective outpatient procedures for the treatment of
spondylolisthesis
and several other spinal conditions.
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