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Lumbar Spondylolisthesis Explained
Getting older brings many changes to our health, some of which can be painful or even debilitating. One degenerative problem that is common with age is called lumbar spondylolisthesis. If you break this big term down, it means vertebra movement. Patients with spondylolisthesis have instability in their spinal column, where one vertebrae abnormally shifts forward over the next vertebrae. NYC Spine Surgeon Dr. Fischer at NYU Langone Medical Center in NYC is experienced in helping patients deal with this painful spinal condition.
What are the symptoms?
The tell-tale signs of lumber spondylolisthesis are different than most other spinal conditions. The most common symptom is pain when standing or bending, such as over a countertop or sink. Standing for long periods of time can be difficult. Nerves that are compressed in the spine also may cause pain that extends down the buttocks, legs and feet. Weakness and numbness are also possible symptoms of spondylolisthesis.
How is it diagnosed?
This spinal condition is usually diagnosed with a series of X-rays taken along the lumbar spine in both the extended and flexed positions. An MRI may also be performed to see the spinal column in more detail, as well as determine the degree of nerve compression if that is present. Lumbar spondylolisthesis most commonly occurs between the 4th and 5th lumbar vertebra.
Can I avoid surgery?
NYC Spine Surgeon Dr. Fischer at NYU Langone Medical Center approaches lumbar spondylolisthesis conservatively when possible by recommending a nonsurgical treatment plan. The first step is taking oral medications such as ibuprofen to treat pain and inflammation. Physical therapy is also usually advised to treat symptoms and strengthen the spine. If these methods aren’t sufficient, injections into the spinal canal or joints may be prescribed to reduce pain and swelling. If the injections don’t relieve symptoms for several months, NYC Spine Surgeon Dr. Fischer will likely recommend another treatment.
What if I need surgery?
Surgery is the final resort for patients with lumbar spondylolisthesis. The typical procedure involves decompression, which removes bone and disc to open the space for nerves in the spinal canal, and fusion to stabilize the spondylolisthesis. Bone grafting is performed to grow bone between the vertebra to help them fuse together. NYC Spine Surgeon Dr. Fischer will discuss possible surgical techniques with you as both open or minimally invasive options are available. Surgical risks vary depending on the technique, with some common potential risks including infection, bleeding, nerve damage, failed fusion, or adjacent disc degeneration. For patients with severe lumbar spondylolisthesis, the benefits typically outweigh the risks.
What is recovery like?
Recovery after surgery depends on each patient’s age, surgical method, and general health. Most patient’s stay in the hospital from 1 to 3 days, with walking starting soon after surgery. Further activities will be introduced gradually, with more intense exercise sometimes delayed up to 6 months. Each patient is unique and NYC Spine Surgeon Dr. Fischer will help you determine what is best for you and your health.