Spondylolisthesis

Spondylolisthesis is traditionally defined as an anterior displacement or slippage of a vertebral body in relation to the segment immediately below.

The Greek origin of this word is spondylos, meaning “vertebra,” and listhesis, which refers to “slippage or displacement” but without regard for direction.

WILTSE CLASSIFICATION

Type 1: Dysplastic

Type 2: Isthmic (pars) – Subtype A, B and C

Type 3: Degenerative

Type 4: Traumatic

Type 5: Pathologic

Type 1: Dysplastic

• This type is a congenital anomaly (birth defect) that allows displacement of most often the posterior elements of L5/S1 spinal level
• The condition of Spina bifida is usually seen with these types
• This type only occurs 1:4 ratio compared to isthmic type 2a and is quite uncommon

Dysplastic

Type 2A: Isthmic

• Occurs with a dissociation of a part of the vertebra known as the pars interarticularis from repeated activity
• The most common location of the spine that this type occurs is at the L5/S1 level
• Not seen in newborns
• It is Also known as a Spondylolysis

Type 2B: Isthmic

• This is an elongation of the vertebral aspect known as the pars interarticularis
• Initially, it is the same as Type 2A, but then healing occurs after the slippage and heals as an elongated structure

Type 2C: Isthmic

• This type occurs with an acute fracture of the pars interarticularis
• It is quite uncommon for an acute injury to affect the pars only
• This type is rarely seen and occurs with extreme traumatic lower lumbar extension

IsthmicDegenerative

Type 3: Degenerative

• This type occurs most often in patients over the age of 60.
• This type occurs with long standing degeneration of an aspect of the vertebra known as the facet joints as well as the disc. This type does not have an interruption of the pars interarticularis and most commonly is seen at the L4/L5 level of the spine. We typically see a 10-15% slip and no more than 25% slippage.

Traumatic

Type 4: Traumatic

• This type occurs because of an injury causing fracture of part of the posterior arch of the vertebra and not the pars interarticularis.
• It will usually occur in the cervical spine (neck) of patients that present with this type.

Pathologic

Type 5: Pathologic

• A pathological spondylolisthesis occurs with general or local bone diseases such as metastasis, Paget’s, or osteopetrosis to name a few.

 

Grading a Spondylolisthesis

The most common grading system for spondylolisthesis is the Meyerding grading system. It grades based on the severity of slippage of the vertebra that has occurred. The grades as are follows:

Grade 1 is 0–25%
Grade 2 is 25–50%
Grade 3 is 50–75%
Grade 4 is 75–100%

Over 100% slippage is known as Spondyloptosis and is classified as such when the vertebra completely falls off the supporting vertebra.

(Yochum and Rowe, 2003)

How We Help Those With This Condition:

At Hinterland Chiropractic, we deal with this condition quite frequently. Our main goal for treating patients with spondylolisthesis is to provide the safest and most comfortable care possible. We focus on restoring optimal spinal mechanics as well as improving posture and proper alignment of the spine. Our focus is not to reduce the amount of slippage that has occurred, but to adjust the spinal joints above and below the vertebra affected which addresses the neurological and mechanical causes of the spondylolisthesis.

In turn, patients notice improved motion and decreased pain and stiffness in the region of complaint! Our chiropractors strive to help you return to your daily activities as quickly and efficiently as possible and help you prevent any further issues and keep you and your body functioning at your full potential.

Depending on the case, our chiropractors may have you perform specific exercises and stretches to help in your recovery to full function.