Low back pain that is worse with extension? Do you have a family member with spondylolisthesis? Do you have degenerative joint disease in the lumbar? Then you may have lumbar spondylolisthesis.
What is a lumbar spondylolisthesis?
Spondylolisthesis refers to the forward slippage of one vertebral body to the beneath it. This most often happens at L5 and S1 but it can occur at higher levels.
There are six types of slippage graded I-VI.
- Type I: Congenital/Dysplastic caused by congenital anomaly
- Type II: Isthmic caused by pars fractures and is most common at L5 and in youths
- Type III: Degenerative caused by degenerative joint disease and is most common at L4
- Type IV: Traumatic caused by trauma resulting in a pedicle fracture
- Type V: Pathological caused by an underlying pathology
- Type VI: Iatrogenic caused by surgery
Imaging of the lumbar spine is the only definitive way to diagnose lumbar spondylolisthesis.
What causes lumbar spondylolisthesis?
The cause of lumbar spondylolisthesis is unclear however certain factors seem to be prevalent in patients with lumbar spondylolisthesis.
- Sports that require a lot of hyperextension such as gymnastics
- Degenerative joint disease
What are the symptoms of lumbar spondylolisthesis?
Lumbar spondylolisthesis is often asymptomatic. When symptoms do occur they can present in several ways.
- Low back pain made worse with extension
- Hamstring tightness
- Hyperlordosis of the lumbar or thoracolumbar spine (sway back)
In extreme cases:
- Gait disturbance
- Neurogenic claudication
What are the treatments for lumbar spondylolisthesis?
- Chiropractic adjustments (unless instability is present)
- Physical therapy
- At home exercises and stretches (avoiding extension exercises)
- TENS unit
- Reduction of activity during periods of aggravation
- Orthopedic intervention if grade III – V
If you are experiencing lumbar spondylolisthesis and wish to discuss your treatments options, please schedule your appointment today.