Spinal Instability

Spondylolisthesis: what is it?

Spondylolisthesis is a condition in which one vertebra in the spine shifts forward in relation to the vertebra below, resulting in instability and potential compression of the spinal nerves. This slippage can occur in various parts of the spine, but it is most common in the lumbar region (lower back). Spondylolisthesis can be a painful condition and, in severe cases, can affect mobility and the patient's quality of life.

Spondylolisthesis can have various causes, which are divided into different types. Congenital spondylolisthesis occurs due to a defect in the formation of the vertebrae during fetal development, making them prone to shifting. The degenerative form, the most common in adults, is related to aging and the wear and tear of the spinal joints, which reduces stability. Traumatic spondylolisthesis occurs after severe injuries, such as fractures or accidents, that cause vertebral displacement. Pathological spondylolisthesis is caused by diseases that weaken the bones, such as infections or osteoporosis. Finally, iatrogenic spondylolisthesis is a rare form resulting from complications from previous spinal surgeries.

Symptoms, diagnosis and treatment of Spondylolisthesis

The symptoms of spondylolisthesis vary according to the severity of the slippage and nerve compression. In many cases, it may be asymptomatic or cause only mild pain, especially in the lumbar region, which worsens with activities like walking or standing. If the nerves are compressed, the pain can radiate to the lower limbs, causing symptoms similar to sciatica. The lack of spinal stability can result in stiffness, muscle weakness, and difficulties moving the spine. In severe cases, nerve compression can cause tingling, numbness, or loss of motor control in the lower limbs, as well as problems with balance and coordination, affecting the ability to walk.

The diagnosis of spondylolisthesis is made through a detailed clinical evaluation, followed by imaging tests. The doctor examines the patient's symptoms, performs a physical examination, and requests tests such as X-rays, which show vertebral slippage and the severity of the condition; magnetic resonance imaging (MRI), which provides a detailed view of the spine structures and nerve compression; and computed tomography (CT), which provides detailed images of the vertebrae and possible bone lesions.

The treatment of spondylolisthesis varies according to the severity of the slippage and the patient's symptoms, aiming to relieve pain, restore spinal stability, and improve quality of life.

In most cases, conservative treatment is the first step and includes the use of medications (painkillers and muscle relaxants) to relieve pain, physical therapy to strengthen the spine and abdominal core muscles and improve posture, and the use of orthopedic braces to support the spine. Lifestyle changes, such as regular exercise, weight loss, and postural correction, are also recommended.

When conservative treatment is ineffective or there are severe neurological complications, surgery may be necessary. Options include decompression to relieve pressure on the nerves, spinal fusion to stabilize the vertebrae, and discectomy to remove damaged discs and improve spinal stability.

Although spondylolisthesis cannot be completely prevented, some measures can reduce the risk and improve spinal health. Maintaining good posture, avoiding incorrect postures when standing or sitting for long periods, and engaging in regular strengthening and stretching exercises for the abdominal and lumbar region help improve spinal stability. Additionally, it is important to avoid lifting excessive weights and to use proper techniques to protect the vertebrae, as well as to maintain a healthy weight to reduce pressure on the spinal joints and prevent vertebral degeneration.

Spondylolisthesis is a condition that can significantly affect mobility and well-being, but with early diagnosis and appropriate treatment, most patients will experience symptom relief and improve their quality of life. HPA Saúde offers advanced treatments, including specialized care and innovative rehabilitation techniques, to ensure that each patient receives the most suitable treatment for their condition, promoting safe and effective recovery.