Spondylolisthesis occurs when vertebral body moves forward, backward, or to either side, causing the vertebral body is not aligned with the next vertebral body. The most common locations to have spondylolisthesis are between the fourth lumbar vertebra and the fifth vertebra and between the fifth vertebra and the first sacral vertebra. Of the various causes for spondylolisthesis, the most common causes are degeneration and arcus vertebra fracture.
The early symptom for spondylolisthesis is back pain. Back pain may be in the lower back or hips. The back pain may get worse due to activities and may be relieved after rest. If spondylolisthesis continue to deteriorate, nerve compression may occur. The symptoms of nerve compression are similar to those of spinal stenosis or sciatica.
Spondylolisthesis is diagnosed with X-ray. However, CT or MRI is required to evaluate if nerve compression occurs.
Most patients may receive non-surgical treatments, such as rest, taking pain medicine or rehabilitation. Nerve compression may be treated with spinal epidural steroid injection or selective nerve root injection. If the symptoms do not subside after 6-12 weeks of treatments, surgery is recommended.
The surgery will solve two issues. One is nerve compression and the other is the instability in the vertebral body. Nerve decompression surgery is the solution to nerve compression, while the instability of vertebral body requires arcus vertebra screw spinal fusion surgery. CMUH has been providing computer navigated minimally invasive surgery to minimize the destruction, achieve immediate stabilizing effects, improve back pain, and enhance bone fusion.