What Are Treatment Options for Spondylolisthesis?

Spondylolisthesis — it’s a mouthful to say, but it is nothing to smirk at. It can be a source of significant pain, causing restricted mobility, numbness and in rare cases even incontinence. Fortunately, if you’ve been diagnosed recently with this condition, relief is in sight. Modern medicine offers a number of excellent treatment options for spondylolisthesis, with surgery being considered only as a last resort.

Understanding spondylolisthesis

What, specifically, is spondylolisthesis? It’s a condition of the spine, usually occurring in the lower back, in which one of the vertebrae slides forward onto the vertebra below. In mild cases, there may be no symptoms, and a person may not even know he has the condition. However, quite often, the displaced vertebra puts pressure on the nerve, causing pain in the lower back, buttocks or legs, and sometimes numbness or weakness in the legs. In rare conditions, if the right nerves are pressed, the patient may even experience loss of bladder or bowel control.

Spondylolisthesis is categorized generally into three types:

• Degenerative spondylolisthesis — the most common variety, typically occurring with age
• Isthmic spondylolisthesis — occurring as a secondary effect of spondylolysis (stress fractures in the vertebrae)
• Congenital spondylolisthesis — resulting from bone deformities at birth

Common non-surgical treatment options for spondylolisthesis

As serious as this condition sounds, there are a number of non-surgical treatments available to mitigate and manage the pain. These include the following:

• Rest. For acute bouts of pain, your doctor may recommend temporary restricted motion and rest to stop aggravating the injury.
• Physical therapy. Through strategic movement, and learning the right types of low-impact exercise, you can strengthen the muscles surrounding the affected area, which helps you stabilize the back while regaining mobility.
• Medication. The pain can be managed by any of a number of over-the-counter pain medications, including Tylenol or anti-inflammatory medicines. In cases of extreme pain, the doctor may prescribe restricted doses of stronger pain medications and/or muscle relaxants. (In many cases, we prefer to use medication as a supplement to other forms of treatment, rather than as a treatment in itself.
• Epidural steroid injections. For patients suffering significant pain or numbness in the back or legs, an epidural steroid injection can reduce inflammation and relieve pain.
• Back bracing. Primarily used for patients with isthmic spondylolisthesis, a stabilizing back brace can immobilize the affected area and give it time to recover.

Regenerative injection therapy

In recent years, regenerative injection therapy has proven to be a useful tool in treating certain patients with spondylolisthesis. This therapy involves extracting, concentrating and injecting regenerative cells from the patient’s own body into the affected area to stimulate the body’s self-healing functions. The doctor may recommend one of two types of injection therapy, either of which can facilitate and accelerate healing and bring lasting relief:

Platelet-rich Plasma (PRP) Therapy

With this procedure, the doctor draws blood from the patient and separates the plasma, which has a high-concentration of platelet blood cells to aid in clotting and tissue regeneration. The plasma is then injected at the affected site.

Stem Cell Therapy

This procedure involves extracting stem cells from fatty tissue in the abdominal area and reintroducing them at the point of injury. The stem cells have the ability to differentiate into new specific cells, replacing damaged or dead tissue and aiding in healing.

Surgery

When other non-surgical treatments have been explored and exhausted, surgery remains an option for long-term relief of spondylolisthesis. Depending on the type of injury and specific conditions, the surgeon may elect to do one or more specific procedures to correct the problem. The two basic goals with these procedures are decompression (relieving pressure) and stabilization. The most common types of surgery used to correct spondylolisthesis are: laminectomy (removing the part of the bone causing pressure); and/or spinal fusion (fusing the vertebrae together to stabilize the affected area). In some cases, both procedures may be done together.

If you suffer from spondylolisthesis, the good news is you don’t simply have to live with the pain. You have many treatment options available, including many non-surgical treatments, and the prognosis for recovery is very good for most patients. To learn more about your options for treatment, call Polaris Spine and Neurosurgery Center at 404-256-2633.