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Spondylolisthesis (Cervical)

Spondylolisthesis occurs when one vertebra slips forward on the adjacent vertebrae.  

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• Symptoms

• Conservative Treatments

• About this Condition

• Surgery

• Anatomy

Symptoms

 Neck pain that extends toward the shoulder, between the shoulder blades, and even pain in the

 back of the head. There may also be radicular symptoms with pain, numbness, or weaknessextending into the arms or legs. f severe, loss of coordination and bowel or bladder incontinence

may occur.

About this Condition

Spondylolisthesis occurs when one vertebra slips forward on the ad!acent vertebrae. This will

 produce both a gradual deformity of the spine and also a narrowing of the vertebral canal. t isoften associated with pain.

"Source# $edtronic%

This content is for your general education only. See your doctor for a professional diagnosis and

to discuss an appropriate treatment plan.

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Conservative Treatments

Medication and Pain Manaement

The goal when prescribing medications should be maximum reduction of pain and discomfort

with minimal risk of overuse of the medications and avoiding side effects.

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 Non'steroidal anti'inflammatory medications (NSA)s* include common over'the'counter drugs

such as aspirin, ibuprofen and naproxen among others. These drugs are potent long'term pain

reducers that work without concerns of dependence.

+pioid therapy to control chronic back pain is less ideal because of potential toxicity to the body

and physical and psychological dependence. Treatment by this class of drugs should generally bea short term option when patients do not respond to alternatives.

ain can often be reduced through the use of muscle relaxants, anti'sei-ure pain medicationssuch as Neurontin, Topamax, and yrica, anti'depressants, and oral steroids.

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Physical Therapy ! "ccupational Therapy

hysical and occupational therapy can play a vital role in your recovery. +nce acute pain

improves, your doctor or a therapist can design a rehabilitation program to help prevent recurrentin!uries.

These programs often include heat, cold and electrotherapy to help alleviate pain, decrease

swelling, increase strength and promote healing. $ethods include therapeutic exercise, manual

therapy, functional training and use of assistive devices and adaptive e/uipment to increasestrength, range of motion, endurance, wound healing and functional independence.

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#njections

n some cases, your doctor may give you an in!ection of a corticosteroid to help relieve your pain

and reduce inflammation. Corticosteroids mimic the effects of the hormones cortisone andhydrocortisone, which are made by the outer layer (cortex* of your adrenal glands. 0hen

 prescribed in doses that exceed your natural levels, corticosteroids suppress inflammation, which

in turn relieves pressure and pain. They are most effective when used in con!unction with a

rehabilitation program. n addition, corticosteroids can cause serious side effects, so the numberof in!ections you can receive is limited1usually no more than three in one year.

A steroid is often combined with an anesthetic and in!ected into the area around the irritated

spinal nerves that are causing the pain. This area is called the epidural space, and it surrounds thesheath'like protective membrane, or dura, that covers the spinal nerves and nerve roots. Steroids

reduce nerve irritation by inhibiting production of the proteins that cause inflammation. Theanesthetic blocks nerve conduction in the area where it2s applied, numbing the sensation of pain.

An epidural spinal in!ection may be done either for diagnostic or therapeutic reasons. &yin!ecting medication around a specific nerve root, your doctor can determine if that particular

nerve root is the cause of the problem. 0hen administered for therapeutic reasons, a spinal

epidural in!ection may provide long' or short'term relief, anywhere from a week to several

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months. n some instances, an epidural spinal in!ection may break the cycle of inflammation and

 provide permanent relief.

t2s important to note, however, that an epidural spinal in!ection is typically not considered a curefor symptoms associated with spinal compression. 3ather, it2s a treatment tool that a doctor can

use to help ease pain and discomfort as the underlying cause of the problem is being addressedthrough a rehabilitative program such as physical therapy, or while the patient is considering

surgical treatment options.

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Surery

M$T%& Microdiscectomy

A minimally invasive discectomy is an operation that involves using either endoscopic or

microscopic techni/ues to access and treat the spine. +nly that portion of the herniated disc,which is pinching one or more nerve roots, is removed. The term discectomy is derived from the

atin words discus (flat, circular ob!ect or plate* and 'ectomy (removal*.

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M$T%& Minimally #nvasive 'emilaminectomy

A hemilaminectomy is a spine surgery that involves removing part of one of the two laiminae on

a vertebra to relieve excess pressure on the spinal nerve(s* in the lumbar spine, or lower back. A

hemilaminectomy can be performed to relieve symptoms such as back pain and radiating leg pain. A $4T3x hemilamectomy is a minimally invasive procedure performed utili-ing $4T3x

technologies.

n a traditional open lumbar laminectomy the two laminae and spinous process of a vertebra are

removed to relieve excess pressure on the spinal nerves in the spine. The term laminectomy isderived from the atin words lamina (thin plate, sheet or layer*, and 'ectomy (removal*. A

laminectomy removes or 5trims6 the lamina (roof* of the vertebrae to create space for the nerves

leaving the spine.

Anterior Cervical iscectomy with usion

Anterior cervical discectomy with fusion is an operation that involves relieving the pressure

 placed on nerve roots, the spinal cord or both by a herniated disc or bone spurs.

Through a small incision made in a natural deep skin crease in the front of the neck, the surgeon#

• 3emoves the intervertebral disc to access the compressed neural structures

• laces a bone graft to fuse ad!acent vertebrae

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• n some cases, implants a small metal plate to stabili-e the spine while it heals

• n certain cases, an artificial disc may be placed

 

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"pen *aminectomy

aminectomy is an operation that involves removing a portion of the bone over and7or around

the nerve roots to give them additional space. 8our surgeon removes a portion of the lamina, the bony rim around the spinal canal, if it is contributing to pressure on the spinal cord or nerve

roots.