If you have a low back problem and you’ve been told you have spondylolisthesis, you should learn all you can about it, and the simple measures you can take to protect your low back health.
I have had a back problem since I was 12 when I fell during track practice in jr high school, my foot actually got caught up on a hurdle and I landed on my tailbone.
It didn’t phase me much as a kid, it became really bothersome in my 20s which was in the 1980s and it really seemed to get worse in 2001 after I was rear ended and then pushed into the car in front of me while I was sitting at a red light.
Throughout the years I did what doctors told me, try this and that here do this, no do that some doctors were just rude and just thought because I was in my 20s in the 1980s I was looking for pills. I hate pills. None of them listened to what I was saying.
Those are the doctors I fired. How dare they assume that because of my age I was a drug seeker.
I mean they could have at least gave me an X-ray or MRI of my back they just assumed ……and I was dismissed or offered a cortisone shot and if I refused which I did I was ignored and called a non compliant patient. I swear this went on for at least a year or two.
Also after my car accident it got to where I could hardly hold a cup without it falling out of my hand.
I thought the problem was me. I thought maybe I am not explaining myself or my symptoms right.
If only I could just find the right combination of words, maybe then doctors would understand and listen and not think I am a pill seeker and provide me with the treatment I needed. I’m just asking to look at it take an X-RAY or an MRI DO SOMETHING!
I didn’t want any damn pill, and I sure as hell didn’t want a short of cortisone. I rarely took an Advil let alone any other pill.
Pills always seemed to have more complications connected to them then they were worth.
Yes I was one of the nerds that would read any inserts, or talk to a pharmacist about any meds and often left without the pills prescribed because often the side effects were not worth it at the time.
In the 1980s I was a young mom who didn’t wanted to feel in the fog, I drove her to school, dance class and just would never chance the effect of a pill to kill my day…..plus my 1st husband was abusive so I had to be on guard at all times.
But that’s a story for another time.
When I finally went to a doctor that actually listened to me I was thrilled she was an Osteopath she gave me exercises that would help the back and muscles, she sent me for an x-ray had me walk and said my gait was off so I got and insert for my shoe that she made foe me free out of foam, she also told me my one leg was 1/2 inch different in length so she made me an insert for heal 1/4 inch thick dense foam, it helped for awhile but didn’t take away all my pain.
I was sad when she moved to another state and she referred me to a PT.
For years my pain was improved but not gone, I followed and completed my exercises daily or a few times a week as I was told by my PT was told it was most likely arthritis , then osteoarthritis but one day in 2005 I was really hurting and my Doctor scheduled me for an MRI vs X-ray as I was having more and more pain.
I was told I most definitely had osteoarthritis but little did I know I had something worse that I didn’t find out for years later, even though it was written in my chart.
I actually had something called Spondylolysis in My L5 S1 area and also above it.
What is spondylolysis?
I was also diagnosed with Spondylolysis – Spondylolysis. Pars defect. Stress fracture. These three terms are used interchangeably, all referring to the same condition. Spondylolysis is a stress fracture through the pars interarticularis of the lumbar vertebrae. The pars interarticularis is a thin bone segment joining two vertebrae. It is the most likely area to be affected by repetitive stress. This condition is fairly common and is found in one out of every 20 people.
What are the symptoms of spondylolysis?
Spondylolysis doesn’t always have symptoms. When it does, the only symptom is usually back pain.
The pain often gets worse with activity and sport, and is more notable when bending backward.
Generally, the pain doesn’t interfere with everyday activities. If it persists, it is recommended to seek medical attention.
It’s very bothersome when I walk more than say a mile. It also hurts when the weather changes.
What are the risk factors for spondylolysis?
Being human and walking upright is the most basic risk factor for spondylolysis.
The natural inward curvature of the lower back puts stress on the pars interarticularis.
Certain sports that involve excessive or repetitive bending backward may increase the risk of spondylolysis.
Examples include gymnastics, football and soccer.
Young athletes may sometimes develop spondylolysis as a result of over use and hyperextension of the lower back. Genetics could also be a risk factor for some people.;
Spondylolysis Diagnosis
If you have long-lasting, localized low-back pain, it could be due to spondylolysis.
An X-ray is sometimes sufficient to defect a stress fracture. However, if pain persists despite rest and physical therapy, additional imaging may be necessary.
Your doctor may need to order an MRI, a CT scan or SPECT scan of spine for a definitive diagnosis.
Spondylolysis Treatment
Spondylolysis treatment focuses on managing the pain and helping you return to your daily activities. This condition doesn’t typically put you at risk for spinal cord injury or nerve damage.
Depending on the degree of pain, treatment options include:
- Rest/break from sports
- Nonsteroidal anti-inflammatory drugs
- Physical therapy for muscle strengthening and general conditioning
- A lumbar brace
Surgery to repair the fracture is rarely needed, as the pain is expected to fade over time in most cases.
Surgery for Spondylolysis
Surgery may sometimes be an option for adolescents with lumbar spondylolysis. The fracture can be repaired by using a strong titanium screw. This surgery is done by making a 2- to 3-inch incision in the middle of the lower back. The screw is placed to secure the two sides of the fracture together, providing some compression across the area. Then a bone graft (a piece of bone from elsewhere in the body) could be used to further support the repair.
The surgery takes three hours, followed by two or three days in the hospital for recovery.
I will pass on any surgery unless it’s a must!!!
Your doctor may also recommend a surgical procedure such as spinal fusion if it’s found that spondylolysis has caused your vertebra to slip forward. This slippage is called spondylolisthesis, which is a different but related condition.
Mine has slipped forward and yes it’s a nagging constant all day just about every day pain.
Spondylolisthesis Is Not The Same As A Slipped Disc—But Does Involve Slippage
Slippage is a key element of spondylolisthesis.
They like using the word “slippage” because it conjures up a visual image of what’s happening in the body. He explains, “When you have spondylolisthesis, one of the vertebrae—the bones that make up your spine—slips out of place over another.”
However, it’s not the same thing as a slipped disc.
It’s gotten to the point that, I have lived with so much pain all the time the average person would be in agony and I am still doing what I can throughout my day. I would probably try to run a marathon if I had a totally painful day.
The grades
- Type I (less than 35%)
- Type II (25-50%)
- Type III (50-75%)
- Type IV (75-100%)
- Type V (spondyloptosis)
Reference
https://physicaltherapyfirst.com/blog/2020/10/19/spondylosis-spondylolysis-and-spondylolisthesis/
Joint Purpose 
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