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Slipped Vertebrae

Symptoms of back pain rarely go unnoticed though they may range from moderate discomfort to debilitating. Just as the degree of your back pain may vary, the cause of the pain often does as well.

Spondylolisthesis, also known as slipped vertebra, is a term that describes when one of the bones of the spine slips out of place in relation to the vertebrae below it. This slippage may be painless, but often results in pain that radiates from the back to the buttock and thigh.

The slipping of vertebra can be caused by various underlying causes that disrupt the normal architecture of the vertebrae. Spondylolisthesis can occur at any level of the spine, but most frequently in the lower back.

Spondylolisthesis can cause serious complications if the slipped vertebra is severe enough that it compresses the spinal cord or nerve roots. Rarely, this can result in cauda equina syndrome, with symptoms that include a sudden loss of ability to walk with numbness or weakness of the legs, bowel or bladder incontinence, and sudden onset of severe back pain. Cauda equina syndrome should be treated as a medical emergency and requires immediate surgical intervention.

Symptoms

  • Focal back pain that may be sharp or severe during activities and usually relieved with rest or sitting
  • Back stiffness
  • Pain radiating from back to buttock or thigh
  • Numbness or weakness in the legs
  • Spasms of leg muscles
  • Change in posture or gait

Causes

  • Degenerative - bony changes of vertebrae and deterioration of intervertebral discs
  • Traumatic - such as young athletes who develop stress fractures of the vertebrae from overuse, or trauma like car accidents or fall
  • Congenital - birth defects
  • Underlying cause - disorders that affect bone strength like osteoporosis, cancer, or infection

Risk Factors

  • Participating in sports where the risk of back trauma or overuse is present, such as with football or gymnastics
  • Occupations where risk of back trauma or overuse is present
  • Osteoarthritis

Diagnosis

  • Physical examination of the affected area
  • X-ray to check bone alignment and the presence of arthritis
  • MRI or CT scan to show potential soft tissue damage

Treatment Options

  • RICE therapy: Rest, Ice, Compression, Elevation
  • Nonsteroidal anti-inflammatory medications for pain relief
  • Corticosteroid injections for pain relief
  • Physical therapy
  • Surgical stabilization and decompression may be necessary if symptoms do not improve over time.
  • A rare but critical complication of spondylolisthesis is cauda equine syndrome, which is considered a medical emergency and requires immediate surgical intervention