Understanding the problem
Spondylolisthesis occurs when there is abnormal alignment of the spine when seen from the side (lateral view). The vertebra above slides forward relative to the one below it. This malalignment may result from several causes, including trauma or degeneration. There may be abnormal spinal motion associated with this condition.
Some people develop this condition because of an overuse injury called “”spondylolysis.”” This is a stress fracture of the vertebral bone.
Understanding who suffers
There are five main types of spondylolisthesis, each with a different cause. Spondylolisthesis can be caused by:
- Birth defect in part of the vertebra – this can cause it to slip forward (dysplastic spondylolisthesis)
- Repetitive trauma to the spine – this results in a defect developing in the vertebra, which can cause it to slip (isthmic spondylolisthesis)
- Degeneration with aging (degenerative spondylolisthesis) more common in older people
- Injury or trauma to the spine (traumatic spondylolisthesis)
- Bone abnormality – example caused by a tumor (pathologic spondylolisthesis).
Potential Signs and Symptoms
Spondylolisthesis may present the following symptoms:
- Back or neck pain
- Extremities (hands, feet) can be involved if the spinal cord or nerve roots are compressed or irritated
- Muscle spasms
- Thigh and/or buttock pain
- Tight hamstrings
- Some patient may not have any symptoms
Examinations Usually Required
In the physical exam, a doctor will observe posture, range of motion (how well and how far certain joints move), and physical condition, noting any movement that causes pain. The doctor will examine the spine, note its curvature and alignment, and feel for muscle spasms. Spondylolisthesis can cause abnormal walking, so the doctor will observe this.
Physical exams are the first step in diagnosing this condition. If you have spondylolisthesis, you may have difficulty raising your leg straight outward during simple exercises.
X-rays of your lower spine are crucial for determining whether a vertebra is out of place. The doctor may also look for any possible bone fractures on the X-ray images.
The doctor may order a more detailed CT scan if the misplaced bone is pressing on your nerves.
Proposing Treatment and Why AIMIS
TSurgical treatment may be suggested to treat this condition that has not responded to non-operative treatment.
AIMIS provides minimally invasive extremely specialist technologies in its various surgical options depending on an individual’s problem
The surgical treatment for spondylolisthesis must aim at not only decompressing the nerves, but also stabilizing the spine in an optimal position. Various surgical approaches have been developed to treat adult spondylolisthesis. Excellent results can be obtained with proper surgical technique in correctly assessed patients.
AAIMIS provides a variety of surgical options for degenerative spondylolisthesis depend on each patient case, and surgical options often include a combination of surgical treatments for example decompression, fusion, and instrumentation
AIMIS provides extremely specialist technologies in its various surgical options depending on an individual’s problem and include:
- Minimally Invasive Fusion Surgery
- Minimally Invasive Stabilization Surgery
- Posterior Lumbar Interbody Fusion
- Transforaminal Lumbar Interbody Fusion
- XLIF – or eXtreme Lateral Interbody Fusion, Lumbar Interbody Fusion
- PLIF or Posterior Lumbar Interbody Fusion
- TLIF or Transforaminal Lumbar Interbody Fusion
- Or a combination of procedures
The procedures our experts will recommend depend on a number of factors and type and location of the problem.
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Reputable and Prestigious Surgeons
AIMIS’ skilled team of neurosurgeons, orthopaedic surgeons and ancillary professionals has one of the leading experiences in the world for treating spondylolisthesis & spondylolysis . Our full team are consulted with each case to find the most suitable experienced doctor for the patient’s exact issue, to ensure the maximum potential outcome of treatment.
Getting More Information Before Moving Forward
You may have questions like:
- Can I get more information before I commit to this?
- Can I get a second opinion from you before I commit to this?
- How can I find out the cost before I have any obligation?
What AIMIS Can do:
AIMIS will provide a full review, diagnosis and potential surgical options for your condition, after receiving the relevant examinations and information from you. They will also provide an estimate for your surgical procedure before you decide.
AIMIS’ mission is to the provision of “true” healthcare for those who require it. It provides world leading surgeons using state of the art procedures to optimize potential surgical outcomes, whilst taking care of all arrangements so as to allow concentration on recovery.
AIMIS provide competitive prices for state of the art procedures. We also work with a large range of Insurance companies where your policy allows you to have surgery abroad.
Further information on the problem:
This condition occurs when a lumbar vertebra slips out of place. It slides forward, distorting the shape of your spine. This may compress the nerves in the spinal canal. The nerves that exit the foramen (open spaces on the sides of your vertebrae) may also be compressed. These compressed nerves can cause pain and other problems.
Commonly, the back and neck pain caused by spondylosis is not serious, but in some people chronic pain develops due to their condition. It is unusual for spondylosis to cause serious neurologic dysfunction due to nerve compression. But over time, the degenerative changes of spondylosis can cause spinal stenosis, where the spinal canal becomes narrow, and the spinal cord can become pinched. Therefore, spinal stenosis in the neck or low back can be a complication of spondylosis. Cauda equina syndrome, a syndrome where the nerves at the bottom of the spinal cord are compressed by an intervertebral disc or a mass, is a rare complication of spondylosis that can cause severe nerve problems and must be treated.
Further Information on Increased Risk Groups
Spondylolisthesis has several main causes. Doctors have developed a classification system to help talk about the different causes of spondylolisthesis.
Type I: This is also called dysplastic or congenital spondylolisthesis. Congenital means that you’re born with it. Type I spondylolisthesis, then, is a defect in the articular processes of the vertebra (the part that’s supposed to control the movement of the vertebra; your facet joints are made of the articular processes). It usually happens in the area where the lumbar spine and the sacrum come together: the L5-S1 area. The defect allows the L5 vertebra (your last vertebra in your lumbar spine) to slip forward over the sacrum.
Type II: Also called isthmic, this is the most common kind of spondylolisthesis. With type II spondylolisthesis, there’s a problem with the pars interarticularis, a particular region of your vertebra.
A pars fracture can lead to a mobile piece of bone; the detached inferior articular process can actually move around. This bone fragment, also called a Gill fragment, can pinch the exiting nerve root, so the bone may need to be removed.
Problems with the pars interarticularis can also be called spondylolysis. The word looks like spondylolisthesis, and they are somewhat related. Micro-fractures in the pars interarticularis—the kind that gymnasts, football linemen, and weightlifters are prone to—are a form of spondylolysis. The fractures are called spondylolysis; if the vertebra slips forward because it’s not being held in place properly, it’s called spondylolisthesis.
Type III: Aging can also cause spondylolisthesis. As you grow older, the parts of your spine can degenerate; they can wear out. Usually your intervertebral discs change first. The older you get, the less water and proteoglycan content the discs have—and less fluid makes them less able to handle movement and shock. Less fluid can also cause the disc to thin, and a thinner disc brings the facet joints closer together. Without the disc acting as the cushion, the facets can’t control the spine’s movement as well, and they become hypermobile. Eventually, a vertebra can slip forward because the facets aren’t holding it in place effectively as the spine moves. Type III spondylolisthesis usually happens at the L4-L5 region (the fourth and fifth vertebrae in your low back), and it’s more common in women older than 50 years old.
Type IV: Similar to type II C, type IV involves a fracture. However, it’s a fracture of any other part of the vertebra other than the pars interarticularis. Your facet joints, for example, can fracture, separating the front part of your vertebra from the back part.
Type V: Tumors on the vertebra can also cause spondylolisthesis because they weaken the bones and can cause fractures that split your vertebra, leading to instability and a potential slip.
Type VI: You have this type of spondylolisthesis if surgery caused your vertebra to slip forward. It’s also known as iatrogenic spondylolisthesis, and it’s caused by a weakening of the pars, often as a result of a laminectomy (a typical back surgery, but type VI spondylolisthesis isn’t a typical result of the surgery).
Further examination that maybe required or requested
For further confirmation of spondylolisthesis, a CT scan maybe requested. If the slipped vertebra is pressing on nerves, the doctor may order a myelogram where a special dye injected into the area around the nerves follow-up by an additional x-ray or a CT scan. The image will provide a detailed anatomic picture of your spine, especially of the bones, that will help the doctor to identify any abnormalities.
Why AIMIS for this Surgery
AIMIS strives for excellence in delivering the best surgical outcomes, via the extensive expertise of its prestige surgeons, its technologies, its highly trained staff and superior facilities to provide an individualized and compassionate experience in a comfortable environment. All patients are treated with the individual care they deserve in an effort to provide the best chance of successful treatment.
Other Services Provided by AIMIS
In addition to its Innovative Healthcare, AIMIS provides seamless service along the way. From the start of your journey you’ll know the best flights to take, where you’ll be staying, what paperwork you will need. You will have a personal assistant assigned; from your pick up at the airport, to your accommodation, continuous assistance at your pre-consultation, through surgery and in your postsurgical care. Our Patients have said that they feel they have become "part of our family" and some even asked to stay a little longer! AIMIS is here to assist you in an all you requirements, allowing you to focus on your health and recovery.