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NATIONAL CENTRE FOR NEUROSURGERY

Spondylolisthesis

Spondylolisthesis is anterior displacement of the vertebra as a result of spondylolysis (congenital vertebral arch non-union with its body) or degenerative changes in the intervertebral disc.

Spondylolisthesis occurs most frequently in the cervical and lumbar spine having greater mobility and experiencing a vertical load greaterthan the thoracic spine. According to the causes of the disease, spondylolisthesis is divided into five types :

  1.  dysplasticspondylolisthesis (the most rare type of congenital abnormalities) - a malformation of the sacral vertebrae and the base of the fifth lumbar vertebra (defect of the arc feet vertebra);
  2.  isthmicor spondylicspondylolisthesis (spondylolysis) - triggered by an overgrowth of connective scar tissue at the site of uncoossified foot or vertebral arch stress fracture (fractured due to prolonged excessive loads, overstretching during exercising);
  3.  degenerative (involution) spondylolisthesis - arthritic changes in the joints of the vertebrae, stretching, thinning, degeneration of the intervertebral disc (low back pain), usually in the elderly age;
  4.  traumaticspondylolisthesis - straight spine injuries, a fracture of the vertebra foot or plate arc or facet joint;
  5.  pathologicalspondylolisthesis - a defect in the bone caused by the tumor.

Symptoms

Lumbar level - local pain, which intensify at loads and are distributed in the legs, impaired sensitivity and weakness in the legs, pelvic organ dysfunction, gait disturbance.

Cervical level - local pain, which intensify at loads and are distributed into the hands, numbness and weakness in the hands, dizziness. In some cases, there may be a violation of the movements in the legs and dysfunction of the pelvic organs.

Methods of treatment

  •  Subcutaneous (percutaneous) transpedicular fixation of the spine
  •  Dynamic stabilization of the spine
  •  Decompressive-stabilizing operations with the use of pedicle designs, interbody cages and other implants
  •  Laminoplastics