What is Spondylolisthesis?
December 11, 2009
Abigail was competing in a gymnastics tournament last year and during one of her floor routines, noticed a sharp pain in her low back after performing a series of back hand springs. She said she landed crooked on the last of four back hand springs which resulted in immediate pain in the middle of the low back at the beltline. She has had pain in the low back before and initially, didn’t think this was any different from past episodes but when the pain didn’t improve after a week, she asked her parents if she could see their chiropractor for an adjustment. Her chiropractor took her history and was alerted by the mechanism of injury – the rapid onset of pain after bending backwards and landing crooked during her routine. The low back was carefully examined and during the range of motion testing, Abby’s backward bending test was very painful and limited in motion. When bending backwards at an angle with pressure applied in the low back, sharp pain stopped the test immediately. Her neurological tests were normal and she could bend over and touch her toes – in fact, that felt good. Her chiropractor had a strong suspicion of what had happened and ordered an x-ray to see if the preliminary diagnosis was accurate. The x-rays looked normal but with the history of extreme backward bending and immediate pain onset, a bone scan was ordered which was positive for a stress fracture in the back part of the vertebra. Unfortunately, this meant no gymnastics for 3 months and the use of a low back brace was recommended. The good news is that the back pain was gone within a month and follow-up x-rays 3 months later did not reveal a visible fracture line in the vertebra. Abby was able to resume gymnastics and competed with success and no low back pain.
So, what is spondylolisthesis? Spondylolisthesis is the sliding forward of one vertebra over another. It occurs in about 7% of the western population and up to 30-50% in cultures that carry their young on their back (like a back pack). It is reported that most people who develop spondylolisthesis acquire this between ages 6 and 16 due to a developmental weakness in that part of the spine, though the cause can be traumatic, like in Abby’s case where rapid, uncontrolled backward bending occurs. It can also gradually occur over time (called “degenerative”), usually not found before age 50-60, where no single event can be recalled by the patient. There is also a congenital type that can be hereditary where one is born with it, though most authorities feel it is acquired at an early age. The good news is that it is often stable and does not require surgery. In the more severe case, the nerves and/or spinal cord can get pinched in which case surgery is necessary. The symptoms would then include leg pain, weakness, and/or numbness with or without significant low back pain. Most cases however, can be successfully managed without surgery and do not compromise the nerves or cord.
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Article by Dr. Eric Chludzinski, DC. Dr. Chludzinski is the founder of Hudson Center for Spinal Care located in Bayonne and Scotch Plains, New Jersey. In preparation for his career, Dr. Chludzinski attended St. Peter’s College in Jersey City, NJ graduating in 1998 with a Bachelor of Science in Natural Science. He continued his studies at Life University School of Chiropractic in Marietta, GA graduating in the class of 2002 as a Doctor of Chiropractic. Dr. Chludzinski services all of Union County and Hudson County, including Jersey City, Hoboken, Harrison, Kearny, Newark, Elizabeth, Westfield, Clark, Fanwood, Plainfield, Watchung, Mountainside, Berkeley Heights, and South Plainfield.
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