We’ve made introductions, now time for some educational information. I was asked about a second opinion on spondylolithesis so what better way to help than spread some information.

Spondy what? Perhaps you’ve heard of a spondy, pars defect, or a slipped vertebra. Spondylolisthesis can look and sound like a horrible condition but let’s break it down into some simple terms.

Spondylolisthesis occurs when there is a disruption in the “pars interarticularis” in a vertebra. Wait I thought you said you were doing to make this simple doc? Bear with me..

The Pars interarticularis is simply a section of bone that keeps the vertebra from slipping forward over the vertebra beneath it. The pars is identified by the arrow below.

When the vertebra starts to slip forward, back pain and nerve problems can occur.

A defect in a pars can happen for a variety of reasons. It can be absent from birth, fracture for a variety of reasons, or wear out due to arthritis. There is a wide range of ages seen with this condition.

So you’ve been told by a doctor that you have a spondylolisthesis, now what?

• Up to 5% of people have a pars defect and don’t even know it.

• In high level athletes this number goes up to 8%.

• Stress fractures of the pars has been found to be approximately 15% in American football players.

• In adults who have a diagnosed vertebra slip, only about 24% of them continue to slip forward.

I always advocate for non-operative management first. Many patients can achieve active lifestyles again with activity modification and physical therapy. Spine injections can sometimes play a role. Often times it can take 3-6 months for symptoms to subside.

In the cases of slip progression (the vertebra continues to move forward) intractable back pain, or inability to continue to do what you want to do, then surgery can be an option.

In some cases of spondylolisthesis a patient achieve benefit from a decompression, meaning we make more room for the spinal cord and nerves. In other cases patients may benefit more from fusion.

A lower lumbar fusion can be achieved by a variety of ways. We offer anterior approaches for lumbar fusion. The anterior procedure is achieved by accessing the spine in the front and removing the disc and placing a cage that will eventually fuse the two vertebra together. Screws can be placed through the back through a minimally invasive approach.

Not all patients are the same so treatments might differ from patient to patient.

For more information on spondylolisthesis or if you have have been diagnosed with a spondylolisthesis and would like to be seen by Dr. Molina, please let us know.