Spondylolisthesis is a spinal condition where a vertebra bone slips forward on to the bone below it.
The pain of this condition results from the instability at the level of spondylolisthesis. When the bone slip forwards it causes narrowing of the spinal canal. It can also compress the nerve foramina. This can result in the following symptoms:
- shooting pain down the leg
- numbness or tingling
- difficulty walking significant distances
Usually spondylolisthesis is diagnosed when patients present with symptoms of back pain or leg pain. The radiological investigations that help confirm the diagnosis include x-rays, CT scans of the spine and MRI scans.
- The MRI scan provides information on the extent of spinal canal and nerve narrowing.
- The CT scans are used to understand the bony anatomy and to look for the bony pars defect.
- Static and dynamic X-rays are performed to look for instability in the spine.
The treatment options depend on the extent of spondylolisthesis and the symptoms it causes. Conservative treatment is prescribed for patients who have very mild spondylolisthesis and intermittent back pain. Pain relief medication and physiotherapy are the best forms of treatment.
Surgical treatment may be a consideration when:
- patients do not respond to conservative treatment
- the patient’s symptoms are progressively worsening
- patients have symptoms of neural compression including numbness, weakness or difficulty walking
The goal of surgical treatment is to decompress the spinal canal and spinal nerves. It also aims to bring stability to the spine. The stabilisation component is achieved by inserting pedicle screws or rods and performing interbody fusion. The interbody fusion component of this operation uses multiple techniques.
Depending on anatomical constraints, the options of spinal fusion are:
- Posterior lumbar interbody fusion (PLIF)
- Transforaminal lumbar interbody fusion (TLIF)
- Lateral lumbar interbody fusion (LLIF)
- Anterior lumbar interbody fusion (ALIF)
The team at Neuroaxis have experience in performing all the above spinal fusion options. The choice of surgery is usually guided by a combination of factors. This depends on careful analysis of the patient’s scans and understanding the anatomical limitations if any.
The vast majority of these fusions are performed using keyhole surgery techniques. The spinal fixation part of the operation is commonly performed using the spinal robot.
In the case of an anterior lumbar interbody fusion, an experienced vascular surgeon will assist the operation.
Click here to return to the spine disorders page.
To make an appointment with one of our neurosurgeons, please call 03 9329 4761.