Spondylolisthesis / spondylolysis / instability of the spine
The clinical picture of spondylolisthesis refers to the displacement of two adjacent vertebrae.
If the slippage increases under load, the spine is unstable. Depending on the extent and progression of the spondylolisthesis, there may be accompanying pressure and irritation of nerve structures in the spinal canal (spinal canal stenosis) and/or at the level of the nerve exit holes (neuroforaminal stenosis), which can lead not only to back pain but also to radiating symptoms in the legs (sciatica).
Symptoms
The symptoms can range from chronic back pain to the symptoms of spinal canal stenosis and spinal claudication (see below).
Causes
Slipped vertebrae (spondylolisthesis) regularly occur due to incorrect posture or deformity of the spine. The cause is hyperlordosis (hollow back), in which the vertebral joints are overloaded by an incorrect traction angle and fail (spondylolysis). Spondylolysis is therefore a preliminary stage of spondylolisthesis. This phenomenon is also frequently seen with pronounced scoliosis.
Therapy
Entordosing, straightening physiotherapy to improve posture is crucial to stop spondylolisthesis. This can be combined with facet infiltration under fluoroscopy or facet denervation. If neurological deficits or even bladder disorders occur, surgery is usually necessary. As with facet arthrosis, this includes physical rest, avoidance of major physical exertion, pain and anti-inflammatory medication, physiotherapy and physical measures, orthotic treatment with entorodosis, infiltrations close to the spine, PRT, epidural injections.
