Spondylolisthesis is a condition of the spine characterized by the forward displacement of a vertebra over an underlying vertebra. A significant displacement can cause a compression of the spinal nerves resulting in pain. The two most common types of spondylolisthesis include dysplastic spondylolisthesis and isthmic spondylolisthesis.
Treatment Options for Spondylolisthesis
A majority of patients with spondylolisthesis are treated with a non-surgical approach, comprising of medication, spinal injection therapies, and physical therapy. Surgery is an option for patients with the progressive displacement of the vertebra, pain not improving with conservative treatment measures, and difficulty in performing daily activities. Your surgeon may choose a minimally invasive approach rather than an open approach for the surgery. Both open and minimally invasive techniques relieve the pressure over the spinal nerves and stabilize the spine. Spondylolisthesis is treated with spinal fusion and instrumentation. Spinal fusion is a surgical technique in which the intervertebral disc, present in between two vertebrae, is removed and the adjacent vertebrae are joined with the help of bone grafts. Metal implants such as rods, plates, or screws are used to hold the spine firmly in place, during the healing process. The advantages of minimally invasive spine surgery over open surgery for spondylolisthesis include smaller incisions, less soft tissue damage, minimal blood loss, reduced operative time, minimal post-operative pain, shorter hospital stay, faster recovery, quicker return to daily activities, and less scarring.
The different types of spine procedures performed using minimally invasive technique include:
- Anterior lumbar interbody fusion (ALIF)
- Posterior lumbar interbody fusion (PLIF)
- Lateral lumbar interbody fusion (XLIF)
- Transforaminal lumbar interbody fusion (TLIF)
- Direct lateral lumbar interbody fusion (DLIF)
- Axial lumbar interbody fusion (AxiaLIF)
- Image-guided spine surgery
What steps are to be taken prior to the surgery?
Prior to your surgery, your surgeon will explain the surgical procedure, type of procedure, and its associated risks and benefits to you. You may need to get a medical clearance from your physician for the surgery. Your doctor may also order medical tests, which may include a few blood tests, X-rays or other imaging tests to assess your medical condition.
After the surgery, you will be transferred to the recovery room and your condition will be monitored, till it stabilizes. You may experience slight discomfort, pain at the incision site, muscle spasms in the neck or back, or other related symptoms following the surgery. You may need to wear a lumbar brace to support the spine during the healing process. After surgery, do make sure to keep your incision area clean and dry. You should not drive, smoke, lift heavy things, swim, or use hot tubs. Start your physical therapy as guided by your surgeon. Take the medications as instructed by your surgeon and also schedule a follow-up visit with him.
What are the associated risks and complications?
As with any surgical procedure, there are certain potential risks and complications associated with spondylolisthesis surgery and may include infection at the site of surgery, the risk of adverse reactions to the anesthetic, injury to the nerves or spinal cord, and blood loss. You should immediately call your doctor if you develop any signs of infection such as pain, redness, swelling, or alteration in the quantity or smell of the drainage, or fever over 101° F. In addition, if you have problems with bowel or bladder control or numbness over the genital area, inform your doctor immediately.