TWISTED VERTEBRAE

December 17, 2020 Nicholas Lancaster

Spondylolisthesis (Twisted Vertebrae) Causes

One of the most common spondylolisthesis (twisted vertebrae) causes in adults is degenerative spine conditions that can develop either due to aging or the early onset of intervertebral disc deterioration. Spondylolisthesis (twisted vertebrae) is a condition that occurs when one vertebra slips out of place over the vertebra below. The discs that lie between the vertebrae act as spongy shock absorbers and help to give the spine its stability, as well as its ability to move in many directions. As we grow older, the cartilage and protein that make up the intervertebral discs dehydrate and the outer disc wall (annulus fibrosus) weakens. The facet joints or the points where vertebrae articulate, are required to work harder as an affected disc loses mass, bulges, and/or herniates. The joints themselves begin to deteriorate, which is a sign of spinal arthritis. Spondylolisthesis (twisted vertebrae) can occur as a result, particularly if a set of facet joints are no longer able to provide support between two vertebrae, and an affected vertebra slips loose. The condition usually develops in the lumbar (lower back) region of the spine.

Additional Spondylolisthesis (twisted vertebrae) Causes

Aside from degenerative spinal conditions, spondylolisthesis (twisted vertebrae) can also be caused by:

Stress injuries caused by high-impact sports
Bone diseases
Traumatic injury
Hyperextending the spine (bending backward) frequently or incorrectly

Additionally, the condition can arise in children born with abnormal bone formation in the lumbar spine.

Symptoms

An affected vertebra that slips forward can disrupt other spinal components, such as ligaments, muscles, tendons, and neural structures. As a result, spondylolisthesis (twisted vertebrae) sometimes causes the compression of the spinal cord or a nearby nerve root. Nerve compression in the lumbar spine can cause symptoms of localized pain, shooting pains that travel down the leg and radiating tingling and numbness. Muscle weakness and spasms may also occur.

Treatments

Most doctors initially recommend conservative treatments for spondylolisthesis (twisted vertebrae), especially in cases with low-grade slippage. These non-surgical methods often include pain medication, cold/heat therapy, and physical therapy. In cases of high-grade slippage, spinal stabilization surgery may be required. This could involve the placement of bone grafts, screws, and rods to permanently fix two affected vertebrae together (called fusion). Patients concerned about the causes and consequences of spondylolisthesis (twisted vertebrae) should consult with their doctor or a spine specialist.

Typical Spondylolisthesis (twisted vertebrae) Symptoms

Spondylolisthesis (twisted vertebrae) symptoms can be wide-ranging, as the condition can occur as a mild, moderate, or severe case of vertebral slippage. In fact, some people may have spondylolisthesis (twisted vertebrae) and never realize it. The condition typically occurs in the lumbar (lower back) spine, as this segment of the spine is often placed under extreme amounts of stress. Symptoms will usually manifest if a slipped lumbar vertebra comes in contact with the spinal cord or a nerve root. Symptoms might include:

Lower back pain or pain in the buttocks that can worsen when bending over or twisting
Shooting pains that run down the length of one or both legs; may also affect the hips and buttocks
Muscle weakness or numbness in the buttocks or legs
A tingling or “pins-and-needles” feeling in the hips, buttocks, or legs

Managing Symptoms

A doctor may ask a patient who is experiencing spondylolisthesis (twisted vertebrae) symptoms to discontinue any activities that caused the condition to occur in the first place, such as high-impact sports like gymnastics. The use of non-steroidal anti-inflammatory drugs (NSAIDs) can help to relieve pain and reduce any swelling that may arise as a result of irritated tissues. Physical therapy and exercise are additional treatment methods often used for spondylolisthesis (twisted vertebrae) patients, particularly as a way to rehabilitate and strengthen core (abdominal and back) muscles to better support the spine.

Surgical Treatment

Patients experiencing severe spondylolisthesis (twisted vertebrae) symptoms and high-grade slippage may be asked to consider surgery, especially if there is a danger that the vertebra will continue moving out of place. Decompression surgery can help to relieve pressure placed on the spinal cord or nerve root by a slipped vertebra, but sometimes spinal fusion is also necessary. Spinal fusion is a procedure that attempts to fuse two vertebrae together, using bone grafts and stabilizing hardware, such as support cages, rods, and screws. It is always best for patients with spondylolisthesis (twisted vertebrae) to confirm with their doctor or spine specialist that all non-surgical treatment methods have first been exhausted before consenting to any surgery.

Spondylolisthesis (twisted vertebrae) Diagnosis – Understanding Grade Levels

When a patient receives a spondylolisthesis (twisted vertebrae) diagnosis, he or she will likely hear about their grade level of slippage. Spondylolisthesis (twisted vertebrae) is a spinal condition that occurs when one vertebra slips out of place and over the vertebra below. This condition almost always occurs in the lumbar (lower back) area of the spine. The percentage that the vertebra slips out of place is measured and assigned a grade.

The spondylolisthesis (twisted vertebrae) grading system is as follows:

Grade I – slippage of up to 25 percent
Grade II – between 26 and 50 percent
Grade III – between 51 and 75 percent
Grade IV – between 76 and 100 percent
Grade V – the affected vertebra completely separates from the one beneath it

If you have questions about your spondylolisthesis (twisted vertebrae) diagnosis and grade level, don't be afraid to ask your doctor.

Treatments after a Spondylolisthesis (twisted vertebrae) Diagnosis

If you are experiencing symptoms of back pain and nerve dysfunction and receive a spondylolisthesis (twisted vertebrae) diagnosis, you will likely be asked to follow a particular treatment plan formulated around your specific symptoms and overall situation. In cases of Grade I or II slippages, treatments might begin conservatively, focusing on non-surgical methods to relieve pain. Such treatments often include pain medications, physical therapy, and cold/heat therapy, among others. If the condition was brought on by a particular sport or activity – gymnasts and football players are especially at risk for spondylolisthesis (twisted vertebrae) – you may be advised to discontinue those activities.

Is Surgery Necessary?

Grades III, IV, or V spondylolisthesis (twisted vertebrae) may require surgery, especially if the affected vertebra is expected to continue moving out of place. Spinal fusion surgery may be recommended to halt that movement through the installation of bone grafts, support cages, rods, and screws into the affected area of the spine. You should always thoroughly research any surgical procedures and get a second or third opinion before signing any consent forms.

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