My Spine - Lumbar
What are the symptoms?
Back pain is the most common symptom. Many people are, however,
unaware that they have this condition and it can be completely asymptomatic.
Spondylolisthesis may lead to mechanical back pain and referred pain. When
the slippage is so severe that a nerve root is compressed, it can lead to radic-
ular pain (see the chapter Back Pain).
How is it diagnosed?
It can be diagnosed on X-ray, CT scan and MRI scanning. There are different
grades of spondylolisthesis and the grading is based on the degree of slippage
that has taken place of the one vertebra in relation to the other.
Grade I
Grade II
Grade III
Grade IV
– up to 25% slippage
– 25% to 50% slippage
– 50% to 75% slippage
– more than 75% slippage
MRI scanning is used to evaluate not only the degree of slippage, but also
whether there is compression of any of the nerves.
How is it treated?
As a general rule, Grade I and Grade II slips can be treated conservatively.
The symptoms are generally limited to mechanical back pain and referred
pain. These are treated with the usual conservative therapies of analgesic
medication, anti-inflammatory medication, physiotherapy and chiropractic
treatment. The back can be supported by following an exercise programme
overseen by a biokinetician. A brace can be worn for external support.
Performing facet blocks and facet nerve denervation by radiofrequency can
be very effective. Sacral or epidural steroid injections can also have a posi-
tive effect.
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