Spondylolisthesis typically occurs in the lower back due to instability. It occurs when one level of the spine slips forward on the level below. This results in low back pain and leg pain from pinched nerves. The Greek definition is as follows: spondylo (spine) and listhesis (to slip or slide). It occurs more commonly in African Americans, diabetics, and women over 40.
Lumbar spondylolisthesis typically causes low back pain, leg symptoms (including pain, numbness, tingling, and weakness), and can also cause difficulty walking. These symptoms can vary dramatically, causing some people to be quite debilitated while others can continue with their daily activities. Additionally, the symptoms may vary with time, where flare ups can last for several weeks to months and then improve with time.
When lumbar spondylolisthesis pinches the nerves severely, a condition called neurogenic claudication can result. Walking a certain distance (often a block or two) will cause a feeling of weakness or pain in the legs that requires people to stop and rest. After resting, people can often continue walking. Another sign of neurogenic claudication is preferring to lean over a shopping cart while at the store, because this opens up more space for the nerves in the spinal canal.
In rare cases patients will experience signs and symptoms of cauda equina, which is often a surgical emergency. This is characterized by intense back and leg pain, weakness in the legs, numbness in the groin and buttock area, and difficulties with bowel and bladder function. If you experience these symptoms go to an emergency room immediately.
X-rays show bones and can demonstrate the slippage associated with spondylolisthesis. Specialized x-rays with flexion and extension views of the trunk may more precisely demonstrate instability.
With persistent back and leg symptoms that are unbearable or have lasted longer than a month, an MRI is often necessary. MRI scans, unlike x-rays, have the ability to illustrate pinched nerves.
Spondylolisthesis may be prevented by avoiding the following: improper lifting, excessive body weight, repetitive strenuous activity, and smoking.