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Spondylolisthesis Treatment

Orthopedic Surgery

How is spondylolisthesis treated without surgery?

Although nonsurgical treatments will not repair the slippage, many patients report that these methods do help relieve symptoms.

Physical therapy and exercise. Specific exercises can strengthen and stretch your lower back and abdominal muscles.

Medication. Pain killers and non-steroidal anti-inflammatory medicines may relieve pain.

Steroid injections. Cortisone is a powerful anti-inflammatory. Cortisone injections around the nerves or in the "epidural space" can decrease swelling, as well as pain. It is not recommended to receive these, however, more than three times per year. These injections are more likely to decrease pain and numbness, but will not relieve weakness of the legs.

When should someone with degenerative spondylolisthesis be treated with surgery?

Patients should consider surgery for degenerative spondylolisthesis if they have tried the nonsurgical treatments for 3 to 6 months with no improvement.

Before committing to surgery, your provider will take a close look at the extent of the arthritis in your spine and whether your spine has excessive movement.

DS patients who are candidates for surgery are usually not able to walk or stand, and have a poor quality of life due to the pain and weakness.

When should someone with spondylolytic spondylolisthesis be treated with surgery?

Patients should consider surgery for spondylolytic spondylolisthesis if they have tried the nonsurgical treatments for at least 6 to 12 months with no improvement.

If the slippage is getting worse or the patient has progressive neurologic symptoms, such as weakness, numbness, or falling, and/or symptoms of cauda equina syndrome, surgery may help.

How is spondylolisthesis treated with surgery?

Surgery for both DS and spondylolytic spondylolisthesis includes removing the pressure from the nerves and spinal fusion.

Removing the pressure involves opening up the spinal canal. This procedure is called a laminectomy. Spinal fusion is essentially a "welding" process. The basic idea is to fuse together the painful vertebrae so that they heal into a single, solid bone.