Dr. Pranjal Pandey
Spondylolisthesis Surgery & Treatment Delhi
MBBS, MS (General Surgery), M.Ch. Neurosurgery. A neurosurgeon with over 10 Yrs. years of experience Awarded as the best resident in Neurosurgery and was a regional & zonal winner at TYSA neurosurgery.
SPONDYLOLISTHESIS
Human spinal column is an engineering marvel that supports the weight of the body and allows various movements. From a simplified conceptual standpoint, it can be visualized as a stack of bricks which is connected to each other by joints. A well aligned stack provides maximum stability.
Vertebral bodies in the spinal column maintain their position by means of facet joints and pars interarticularis. They provide a break into the range of movement of one vertebral body over the other.
WHY DOES SPONDYLOLISTHESIS OCCUR
When one (or more) of the bricks in the stack slide forward over each other, then spondylolisthesis occurs. This occurs usually due to
- Degenerative changes in the facet joints and intervertebral discs cause thinning of these “brakes” which predisposes the spine to misalignment.
- Stress fracture or repeated trauma may weaken the isthmus/pars interarticularis that can cause “misalignment in the stack of bricks”. This often starts in childhood or teenage years where chronic repetitive stress may cause microfractures in the pars resulting in listhesis.
Related Treatments
- Brain Tumor Surgery
- Neuro Infections
- Spine Disorders
- Cerebral Palsy
- Dementia Treatment
- Stroke Paralysis
- Brain Hemorrhage Treatment
- Parkinson’s Disease
- Dementia Treatment
SOURCE OF PAIN IN SPONDYLOLISTHESIS
A slipped bone affects the stack and the contents as well. As the vertebral column becomes malaligned, the remaining joints and discs are overstressed. They generally show chronic changes of joint inflammation and disc degeneration leading to pain.
Also the change in alignment compromises the spinal canal and pinches the travesrsing nerves causing pain.
WHAT CAN YOU EXPECT TO FEEL IN SPONDYLOLISTHESIS
- The “Heavy Leg” Feeling: Your legs might feel tired or heavy after walking just a short distance.
- The Shopping Cart Sign: You might find that your back and leg pain feels much better if you lean forward (like leaning on a shopping cart). This “opens up” the tunnel and gives the nerves more room.
- Tight Hamstrings: Many patients feel like the muscles in the back of their thighs are permanently tight, no matter how much they stretch.
- The Step-Off: In some cases, you can actually feel a “step” or a dip in your lower rback when you run your finger down your spine.
SPONDYLOLISTHESIS – HOW DO WE FIX IT?
As a neurosurgeon, my goal is to reduce the slippage of bones, preferably reduce to its original state and keep it stabilized over there. Fractures are stable or unstable will also determine the treatment protocol.
- Internal bracing by strengthening the muscles that keep the spine stable
- Operative reduction by distraction, fixation and fusion.