Dr Adriaan Liebenberg My Spine Explained | Page 42

CHAPTER 7 SPONDYLOLISTHESIS What is it? In spondylolisthesis one of the vertebrae slips forward on the vertebra direct- ly below it. This can lead to the compression of the nerves that exit through the foramina. The disc is also damaged by the forward movement of the ver- tebra. The term spondylolisthesis is a Greek term and is derived from the word ‘spondylos’, which means vertebra, and ‘listhesis’, which means to slip or to slide. There are different types of spondylolisthesis: Inborn (congenital) – In this case the slippage is caused by abnormal bone that does not develop normally at birth and predisposes the vertebrae to slip. Isthmic – In this case there is breakage of the bony elements that support the joints, which in turn are responsible for keeping the vertebrae in place. This breakage is called spondylolysis. Degenerative – In this case degeneration of the discs and facet joints leads to slippage of the vertebrae. Traumatic – Trauma can lead to a fracture of the stabilising complex that houses the intervertebral joint and this in turn leads to the slippage. Post-surgical – Overzealous decompression of the lumbar spine during sur- gery can lead to instability and the inability of the intervertebral joints to stop slippage from occurring. Pathologic – This is when the bone is weakened by a pathological process such as a tumour, infection, bone disease or osteoporosis. 41