More than 3 million people are diagnosed each year with the spinal disorder spondylolisthesis, in which one bone slips onto another. It can impact both adults and children and is common among teenagers involved in athletics.
“Spondylolisthesis is Latin in origin,” said Dr. Isador Lieberman, a spine surgeon with Texas Health Plano. "Spondy refers to spine and listhesis refers to one bone slipping forward on the other bone. They're not lined up in their native alignment."
It's possible to have spondylolisthesis and not know it — doctor's diagnosis is required to identify the disorder. It can be one you're born with that progresses over time. It also can appear in adulthood because of age-related deterioration of the spine. But in either case, Lieberman says the resulting back pain can be treated.
What causes spondylolisthesis? "In the young teenaged age group, it's typically congenital meaning you were born with this and over time it's progressed. In the adult age group, you can get a degenerative spondylolisthesis, which is related to the age-related deterioration of the spine, and one bone slips forward or sideways on top of the other bone. Both tend to be a progressive issue, and you run into pain because the bones are grinding on themselves or because the nerves are being compressed stretched or irritated by the slip of one bone on top of the other."
It occurs commonly in children and adolescents active in athletics: "You promote or you accelerate the slip of one bone on top of the other. And we frequently see this in gymnasts, dancers, football linemen, some baseball pitchers will get a spondylolisthesis like this as well."
You could have spondylolisthesis and not know it? "Absolutely. When we see it on an X-ray we know it's there but we really can't predict how fast it will progress or how much it will progress or how much it will affect our patients. And that's why we monitor these things."
"If we see it rapidly progressing, the patients will complain about the shape of their back first and foremost. So the treatment for that is realign it to bring it back into position.
If we see it on the X-rays, and it's not rapidly progressive and the patients only have minimal back discomfort, we typically rehab them to get them going on an exercise program to maintain their flexibility to maintain their core muscle strength to help support the spine and encourage them to avoid some of the activities that we know can make it worse.
If they start to develop nerve issues, then we have to try to realign the spine and protect the nerves. That's an operation. That's surgery to improve the situation."
Tips for taking better care of our backs:
- "One, we're pushing a lot of the young athletes too hard, too fast, pushing them into more of the strength conditioning and putting a lot of force on the lower spine before that spine is physiologically mature and can handle the force. So I typically recommend maintaining flexibility, agility and stamina as opposed to strength."
- "Keep yourself slim. Keep yourself active. The more weight you carry, the more force on the spine."
- "Bone health and bone quality. In women, it's very important to prevent osteoporosis and the changes that causes over time by keeping up with an active exercise program and maintaining the calcium and vitamin D in their diet to optimize their bone health."
- "Then there's the smoking. The nicotine in the cigarette smoke narrows down the blood supply to the discs, to the muscles, to the ligaments."
- "Squat at the knees to lift instead of bending straight forward and potentially irritating the spine."