Spondylolisthesis

Spondylolithesis, which can cause pain and numbness in the neck, can typically be treated with non-surgical or minimally invasive surgical techniques.
The word spondylolisthesis comes from the Greek words “spondylo,” meaning spine, and “listhesis,” meaning slippage. Spondylolisthesis of the spine is an abnormal slippage of one vertebral bone over another.
Although the slippage of the bones isn’t necessarily inherently harmful or dangerous, the abnormal motion can cause premature degeneration of the discs and pinching of the spinal cord and nerves that live within the spinal canal. That is, the spinal canal (the main opening in the spine where the spinal cord lives) and foramen (the window where the nerves exit) can become narrowed as a result of the abnormal slippage.
You can think about it as two tubes placed end-to-end with electrical cords packed within them. When the tubes are slipped abnormally against one another, the electrical cords can become pinched off.
When a spondylolisthesis occurs in the neck, it can lead to compression of nerves causing pain, weakness, numbness and tingling down your arms.

What causes a spondylolisthesis?

You can develop a spondylolisthesis in many different ways. If the slippage was present at birth, it is called a congenital spondylolisthesis. If the slip occurred later in life, it is called acquired spondylolisthesis. One of the most common reasons acquired spondylolisthesis develops is due to changes related to normal, age-related degeneration of your spine. If the degenerative parts of the spine push against your nerves, you can experience severe pain down your arms. This is often called radiculopathy. If the degenerative parts of the spine push against your spinal cord, you can experience severe pain and/or weakness down your arms and legs. This is often called myelopathy.

Signs and symptoms

In addition to pain, pressure on nerves from spondylolisthesis can also cause numbness, tingling, burning, and weakness in your arm. Severe narrowing of the central spinal canal from the slip can compress your spinal cord leading to balance difficulties, problems using your hands, and even paralysis of your arms and legs. If you experience bowel or bladder problems and have progressively worsening weakness in your arms or legs, you should seek medical attention immediately.

Diagnosis

Orthopedic surgeons first suspect spondylolisthesis when a patient complains of pain radiating from the neck down the arm, especially when bending or twisting the neck. Patients will also commonly complain of numbness, tingling, and burning down their arm. They may also have muscle weakness. If the narrowing involves the spinal cord, symptoms can radiate to the legs as well. After a detailed examination, the diagnosis can be confirmed with plain X-rays (including flexion and extension views) and verified with an MRI or CT of the cervical spine.

Treatment

Most patients with spondylolisthesis can initially be treated conservatively with pain management, physical therapy, and activity modification. For patients with more severe or persistent symptoms, they may benefit from an epidural spinal injection [Linkto: 2.8.3 Spinal Injections]. Patients with very severe symptoms who do not achieve long lasting relief from injections may be candidates for surgery.
One of the more common surgical procedure we use to address narrowing associated with spondylolisthesis is called a minimally invasive decompression (laminoforaminotomy) and is performed through a half-inch incision through the back of the neck. Patients are able to go home the same day as the procedure. This procedure is usually reserved for patients with stable forms of spondylolisthesis. The other time-tested surgical approach involves going through the front of the neck and includes taking the pressure off of the neural elements and fusing the vertebrae to stabilize the spine (anterior cervical decompression and fusion, or ACDF). Your surgeon can go over the advantages and disadvantages of each of these surgical options with you.
The physicians at Orthopedics International can address your spondylolisthesis using the most leading-edge, minimally invasive techniques.

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