I'm sorry your friend is going through this, because it is very painful. To start, let's identify some terms for those who may not be familiar:
Spondylolisthesis-This means you vertebrae are sort of sliding around a bit. If you imagine a spine from the side, the vertebrae are all stacked nicely on top of each other with little cushions in between. Now imagine one of them sliding forward a bit out of alignment while the others stay in place. This is anterolisthesis/spondylolisthesis. As you can imagine, this puts stress on the levels above and below when this vertebrae pulls forward out of alignment. It also means there can be pressure on the spinal cord, which is running up through all those vertebrae. One of them slides forward, and it can pinch the cord.
Spondylolysis-This means a pars fracture. When you look at a vertebrae from behind, you see the little piece of bone that sticks straight back at you that you can feel when you feel your back. That back part connects to the big body of the vertebrae. If you were holding that back part, just in front of your fingers on either side are the pars. That's just the name for the two sides holding that back part to the body of the vertebrae. Spondylolysis means you have a pars fracture, so the spine again can slide around like it shouldn't and can again pinch the spinal cord or the big spinal nerves.
Basically, it sounds like your friend may have an unstable spine. Sometimes if those fractures are very small, they will try rest and bracing to let them heal on their own, like a broken leg in a cast. But often if your back is unstable and sliding around, you put your spine at risk. Any pinching or pressure on your spinal cord can cause dramatic permanent problems. so if it has been two years, it is time to revisit treatment.
Often chronic spondylolistheis requires surgery. They usually will do a fusion. This means they take a little piece of metal and often some bone either from your hip or a cadaver bone and they connect the two or three vertebrae that are sliding around together. Picture those vertebrae again. They take a very small rectangle of metal and screw the top into one vertebrae and the bottom into the other. That steadies them because they are connected. Then they use a little bone graft and a compound that helps grow bone to encourage them to grow together, like a broken bone would. This stabilizes the area by connecting the vertebrae and encouraging them to grow together. They will be stable and strong.
This is a very common surgery and often has really good results. You want to go to a surgeon who does a lot of them, because that is the surgeon who will be better at it. Practice makes perfect, even for surgeons. There will also be physical therapy to support the back. The therapy goals will be to correct posture, and strengthen the muscles that hold the back in place.
Any time your back is unstable, you risk your spinal cord. I hope this helped explain everything. If you have further questions, feel free to ask. This area is one of my specialty areas as a nurse. I'll be happy to explain further. Also, see our back/spine section here on the site.
Medline (through the National Institutes of Health) has a spine section: http://www.nlm.nih.gov/medlineplus/spinaldiseases.html and even a video of a spinal fusion surgery: http://www.orlive.com/jeffersonhospitals/videos/lumbar-laminectomy/transforaminal-lumbar-interbody-fusion?view=displayPageNLM
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Hi Anonymous-
I'm sorry your friend is going through this, because it is very painful. To start, let's identify some terms for those who may not be familiar:
Spondylolisthesis-This means you vertebrae are sort of sliding around a bit. If you imagine a spine from the side, the vertebrae are all stacked nicely on top of each other with little cushions in between. Now imagine one of them sliding forward a bit out of alignment while the others stay in place. This is anterolisthesis/spondylolisthesis. As you can imagine, this puts stress on the levels above and below when this vertebrae pulls forward out of alignment. It also means there can be pressure on the spinal cord, which is running up through all those vertebrae. One of them slides forward, and it can pinch the cord.
Spondylolysis-This means a pars fracture. When you look at a vertebrae from behind, you see the little piece of bone that sticks straight back at you that you can feel when you feel your back. That back part connects to the big body of the vertebrae. If you were holding that back part, just in front of your fingers on either side are the pars. That's just the name for the two sides holding that back part to the body of the vertebrae. Spondylolysis means you have a pars fracture, so the spine again can slide around like it shouldn't and can again pinch the spinal cord or the big spinal nerves.
Basically, it sounds like your friend may have an unstable spine. Sometimes if those fractures are very small, they will try rest and bracing to let them heal on their own, like a broken leg in a cast. But often if your back is unstable and sliding around, you put your spine at risk. Any pinching or pressure on your spinal cord can cause dramatic permanent problems. so if it has been two years, it is time to revisit treatment.
Often chronic spondylolistheis requires surgery. They usually will do a fusion. This means they take a little piece of metal and often some bone either from your hip or a cadaver bone and they connect the two or three vertebrae that are sliding around together. Picture those vertebrae again. They take a very small rectangle of metal and screw the top into one vertebrae and the bottom into the other. That steadies them because they are connected. Then they use a little bone graft and a compound that helps grow bone to encourage them to grow together, like a broken bone would. This stabilizes the area by connecting the vertebrae and encouraging them to grow together. They will be stable and strong.
This is a very common surgery and often has really good results. You want to go to a surgeon who does a lot of them, because that is the surgeon who will be better at it. Practice makes perfect, even for surgeons. There will also be physical therapy to support the back. The therapy goals will be to correct posture, and strengthen the muscles that hold the back in place.
Any time your back is unstable, you risk your spinal cord. I hope this helped explain everything. If you have further questions, feel free to ask. This area is one of my specialty areas as a nurse. I'll be happy to explain further. Also, see our back/spine section here on the site.
Medline (through the National Institutes of Health) has a spine section: http://www.nlm.nih.gov/medlineplus/spinaldiseases.html and even a video of a spinal fusion surgery: http://www.orlive.com/jeffersonhospitals/videos/lumbar-laminectomy/transforaminal-lumbar-interbody-fusion?view=displayPageNLM
March 30, 2010 - 6:26amThis Comment
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