TREATMENT OPTIONS

Spondylolisthesis may be asymptomatic. Associated symptoms include intermittent or persistent pain. When there is associated nerve compromise there may be extremity pain, numbness and in more severe cases weakness. The indications for surgery in younger populations differ from that of older individuals. Indications for surgical intervention include:

• Neurological deficits or signs unresponsive to conservative care
• High grade slippage > 50%
• Type 1 and type 2 slippage with X-ray evidence of obvious instability (increased movement) and lack of response to conservative measures
• Traumatic spondylolithesis
• Associated postural deformity and gait abnormality
• Surgically induced (Iatrogenic) spondylolisthesis
• Type 3 Degenerative type with gross instability (extra vertebral movement) and incapacitating pain.

The goal of surgical intervention is to take pressure off of nerves and to immobilize or stabilize the unstable (hypermobile) segment of the spine.

Conservative care includes:

• Modification of physical activity
  
• Chiropractic care using specific decompression techniques.
• Nutritional anti-inflammatory approach
• Pharmaceutical anti-inflammatory approach
• Back brace
• Physical therapy
• Epidural steroid injection
• Surgical options include:
• Posterior or posterolateral fusion
• Surgical decompression
• Stabilization of involved spinal segment with fusion or cast

 PREVENTION

The best way to prevent neck and back pain and to prevent progressive spine compromise is to become familiar with how your spine works and to become an active participant in your spinecare. It is important to learn how to choose a spinecare specialist and to recognize an efficient spinecare team. There are many steps you can take and habits you can develop to better care for your spine and prevent spine injury. It is also important that you learn more about your spine disorder and become aware of the signs and symptoms that warrant intervention and follow up care. Early detection and timely intervention is generally associated with better treatment outcome.