Spondylolithesis of the Spine: Definition, Causes, & Treatment

August 14, 2013May 24, 2017 / Thomas Cohn, MD

Spondylolithesis is a condition in the spine where one vertebral body has slid forward or backward in relation to another. It is most common in the lumbar area.

As people age, the likeliness of spondylolithesis increases. The presence of spondylolithesis is not necessarily a problem, however it may lead to the spinal cord or nerve roots being compressed. The compression of the spine or nerve roots is often gradual, and sometimes leads to numbness, weakness, and pain especially in the legs. The slippage can also appear without any symptoms; therefore its presence does not necessarily mean that a problem exists. Even very significant spondylolithesis can be present with no or minimal symptoms and can be managed by very minor levels of treatment.

Causes of Spondylolithesis

The slippage in the spine is caused by problems in the posterior elements of the spine – the facets and connecting bony structures. When these joints are not functioning correctly, slippage can occur. Joint damage can occur from:

Birth defects
Physical damage by trauma or stress fractures
Arthritis

Spinal slippage can also result from sports injuries and arthritis as people age.

Diagnosis & Treatment

Spondylolithesis can be easily diagnosed with plain X-rays. Again, the presence of the slippage does not necessarily mean that there needs to be any special treatment. Many people are completely without symptoms. However, if painful symptoms do exist, there are several options for treatment.

Treatment starts with using proper body mechanics for movement, and maintaining core muscle strength. Seeing a physical therapist may help learning the right strengthening and stretching. If spondylolithesis is irritating nerves, more intense physical therapy may be necessary, and working with a pain physician may be beneficial. Chiropractic manipulation of the slippage is not advisable. If significant weakness occurs or bowel and bladder control is lost, then surgical intervention may be necessary.

Tips for Comforting Orthopedic Patients This Summer

August 7, 2013August 14, 2013 / Thomas Cohn, MD

Note: This is a guest post by CastCoverz! Connect with them on Twitter.

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Wear your personality or cover up. Stay clean, dry, snag-free, and comfortable with CastCoverZ! products. Comfort, fun, fashion, and function in the orthopedic world. It’s a challenge, but we’re up to it. Because we know if you Feel Better, you Heal Better!

Osteoarthritis of the Knee – Signs & Symptoms

July 15, 2013September 27, 2016 / Thomas Cohn, MD

As we age, many of us develop knee pain. One of the most common knee conditions is Osteoarthritis – slow degeneration of the cartilage of the knee.

Symptoms of Osteoarthritis

The symptoms of osteoarthritis are:

Gradual onset of stiffness in the joint, especially after sitting for a period of time or lying down
Difficulty bending and straightening the knee
Swelling and pain when first moving the knees, sitting, or kneeling
In more severe cases, the size of the knee may become larger

As we get older, joints in the body age and deteriorate. This starts as early as our twenties, and is more common when we are past forty. Historically, the body was designed to get us to between age forty and fifty. Prior to the onset of modern medicine roughly 150 years ago, disease, trauma, and natural conditions like heart problems killed us by age fifty. So as we age, there is increasing wear from normal use and trauma on our joints including our knees. Weight also often increases as we age and further stresses weight bearing joints.

Factors & Signs

Factors that contribute to osteoarthritis development are:

Age
Trauma
Weight
Genetic tendency (some families may be more prone to its occurrence)

In the doctor’s office, when we examine a knee with osteoarthritis, we usually see a large knee, maybe slightly swollen but not warm, and stiff to move. Plain X-rays will reveal a large joint, often with narrowing of the joint space especially on the inside aspect, and the joint surfaces may appear to be irregular from deterioration.

Read our follow up blog on the treatment options for Osteoarthritis.