For most patients with spondylolisthesis, surgery is not necessary to alleviate the symptoms associated with the condition. Surgical procedures to treat vertebral slippage are typically reserved for traumatic injury patients who have sustained spinal damage due to the extreme forces caused by a car accident or sports injury. Immediate surgical attention is often necessary in these cases, especially since the vertebral slippage is recent enough that other complex spinal components, such as the intervertebral discs, muscles, and ligaments, haven’t had the chance to resettle in abnormal positions. Therefore, surgery to realign the spinal structures is warranted.

Spondylolisthesis is characterized by the forward slippage of one vertebra on to the vertebra below it. Besides traumatic injury, the condition can be caused by a number of additional factors, such as genetic defects of the pars interarticularis (the segment of bone that connects a vertebral body to its facet joint), excessive and repetitive hyperextension (extreme backward bending) of the spine, and bone diseases or spinal infections. Vertebral slippage can also arise as a result of the normal degenerative processes that take place in the spine over time. Intervertebral discs can weaken and collapse from a gradual loss of water content and, as a result, the facet joints are forced to overcompensate and struggle to maintain stability within an unstable vertebral segment. If vertebral slippage eventually occurs, the spinal cord or nerve roots may become pinched or compressed by the displaced vertebra. In some cases, spondylolisthesis surgery will focus on realigning the slipped vertebra, removing pressure from compressed spinal nerves, and stabilizing the affected vertebral segment.

Open Back Surgery

If surgery is necessary to treat a patient with spondylolisthesis, spinal fusion may be the suggested procedure. This highly invasive, open back or neck surgery can be performed from the front, back, or side of the body and requires general anesthesia. The location of entry will depend on several factors, including which direction an affected vertebra has slipped. A large incision is made in the chosen location, and muscles and other soft tissues are dissected and moved out of the way. A surgeon may then use support cages, rods, and screws, to realign and secure a slipped vertebra back into place; and a bone graft may be inserted to help two individual vertebral segments grow into one solid piece of bone. This realignment alone could relieve pressure placed on the spinal cord or nerve roots, but bulging or herniated disc material or bone fragments may also need to be removed for complete decompression. Since this form of spondylolisthesis surgery is highly invasive, the procedure has serious risks, such as bleeding, infection, and bone graft and/or hardware rejection. Additionally, the recovery period after open spine surgery can be long and arduous and a hospital stay of several days is required.

Other Surgical Options

While some patients with high-level spondylolisthesis may require surgery to fuse an affected spinal segment, others may be candidates for a minimally invasive procedure. These procedures are usually performed on an outpatient basis, which means general anesthesia is not required. Instead, local anesthetic and deep IV sedation are used, a small incision is made and an endoscope is inserted, without the need for soft tissue dissection. A surgeon can remove any anatomical material that may be causing nerve compression with the endoscope’s laser and surgical instruments.

If you have a slipped vertebra and need surgery, ask your primary care physician or a spine specialist if you are a candidate for a minimally invasive procedure. You also can do some research on your own and get a second opinion to make sure you have exhausted all the possibilities.

Author Bio: Patrick Foote is the Director of eBusiness at Laser Spine Institute, the leader in endoscopic spine surgery. Laser Spine Institute specializes in safe and effective outpatient procedures for the treatment of spondylolisthesis and several other spinal conditions.

Category: Medicines and Remedies
Keywords: Spondylolisthesis