What is Spondylolisthesis?

A conversation between Dr.Raghava Dutt Mulukutla, Orthopedic Surgeon and Chief of spine surgery & patient

Q. Doctor I am suffering from back pain and leg pain and I am told that my vertebra has slipped forward. What is this?
You are suffering from a condition called Spondylolisthesis. Here one of the vertebra slips forward over the vertebra below.

Q. How does this happen?
There are a number of reasons for this. This could result from anomalies in the spine at birth to fractures and various diseases of the spine.

There are 2 common types

1.The first type when the vertebra slips forward between 4-6 years of age. This may cause back pain or leg pain during childhood or during adulthood.

2.The second type is common amongst women, at about the age of forty. This is due to degeneration and is more common amongst women who are overweight. Sometimes due to extra weight of pregnancy, women come to doctors with back pain and this condition is diagnosed

Q. What are the treatment options for this condition?
Most patients get better with physiotherapy and medication. Once the pain subsides it is important to start exercise programmes to strengthen the back and abdominal muscle. Walking, sports, yoga and swimming are very helpful.

Q. Do I require surgery?
If the pain does not subside with Physiotherapy, medication and restricted activity, followed by exercise, surgeons recommend surgery.

Q. What is the type of surgery that is done?
In children and young adults surgeons sometimes repair the defect that causes the slip. Mostly screws and rods are placed in the spine and the vertebra that has moved forward is brought back to its original position. Cages are also used to maintain the reduction and normal height between the vertebrae.Fusion is routinely done.

Q. How long do I need to take rest? And what are the precautions to be taken after surgery?
Post-surgery, you will be kept under observation in the I.C.U for a day. Following which you will be at the hospital for 4- 5 days. You will be out of bed on the 2nd or 3rd day after surgery and will be given a brace to support your back for a few weeks.

Q. When can I get back to work?
You need 6 weeks of time for light duties and 3 months for heavy work.

Q. Do I need to undergo a lot of physiotherapy?
You hardly require any physiotherapy. A few months after surgery, your physio will teach you a set of exercises which are very easy to follow and do at home.

Q. How painful is the procedure?
The procedure is not that painful and you will be given adequate pain relief medication after surgery.

Q. Can I play games and sports after surgery?
You should play games and sports. Although, you have to be careful while lifting weights at the gym. Your physiotherapist will give you the necessary advice after surgery.

Q. Will surgery affect my married life?
Not at all! You can have a normal married life, women can have babies and undergo normal deliveries.