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Lumbar Spondylolisthesis

The spine is composed of seven cervical, 12 thoracic, five lumbar, five sacral, and three to five coccygeal vertebrae that are stacked one on top of another. Each vertebrae are separated by intervertebral discs (aka “cushions”) on the front part of the spine. Along the back part of the spine, the vertebral bones contact each other on both sides and form facet joints. Lumbar spondylolisthesis refers to the abnormal shifting or “slipping” of one vertebrae from another.  

Symptoms

Some cases of lumbar spondylolisthesis don’t cause any symptoms. Others may cause low-back and leg pain that is worse when standing and walking. Certain positions may improve the pain. Numbness in the legs may occur if this causes spinal stenosis. 

Causes

Lumbar spondylolisthesis may be caused by a break in the middle of the vertebrae that connects the vertebral body to the spinous process (bony projections off the posterior back of each vertebrae). Degeneration of facet joints can also cause abnormal slippage of the vertebrae. Repetitive extension of the spine in gymnasts and football players places these athletes at risk for spondylolisthesis.   

Treatment

Your JLR Center for Pain Medicine physician will work with you to attain an accurate diagnosis a treatment plan tailored to your case.

Conservative treatment of lumbar spondyllisthesis includes anti-inflammatory medications and physical therapy. Minimally invasive procedures such as facet injections, medial branch blocks, or epidural steroid injections may be beneficial if there is superimposed facetogenic pain or nerve irritation. Surgical treatment is an option if the above therapies are not beneficial.