Waist Slip (Spondylolisthesis)

Lumbar slip is a condition in which the anatomical structure of a vertebra is disrupted and slides relative to the adjacent vertebra it is associated with, due to a defect in the posterior elements of our spine.

Spondylolisthesis pain is localized in the lower back and may radiate to the buttocks and posterior aspect of the thigh. Pain may radiate to both sides of the waist and both legs.

Symptoms include:

  • Waist and back pain
  • Muscle tension and stiffness
  • hip pain
  • Pain radiating to the legs (due to pressure on nerve roots)
  • Pain that worsens with activity (increases with movement and standing, decreases with rest)
  • Difficulty standing or walking

Causes and Risk Factors of Waist Slippage

There are six main types of spondylolisthesis:

Congenital spondylolisthesis: One vertebra is defective from the time a person is born.

Isthmic spondylolisthesis. This is caused by another condition called spondylolysis. In spondylolysis, a fracture or crack in the thin part of a vertebra can cause the vertebrae to slide backwards, forwards, or over a bone underneath.

Degenerative spondylolisthesis: Over time, the discs between the vertebrae dry out and become thinner. This thinning makes it easier for a vertebra to slip out of place.

Traumatic spondylolisthesis: Injury or trauma causes the vertebra to slip out of place.

Pathological spondylolisthesis: Osteoporosis or another condition, such as cancer, causes it.

Iatrogenic spondylolisthesis: A vertebra slips after spine surgery.

Imaging methods are of great importance in the diagnosis of spondylolisthesis.

  • X-ray: The amount and angle of slip are evaluated in dynamic radiographs taken especially when bending and straightening.
  • Computed tomography
  • MRI imaging

Spondylolisthesis is graded according to the rate of slippage in the vertebrae. Low grade ones (I or II) have milder symptoms, mostly mechanical low back pain complaints, and usually do not require surgery. It is more serious in higher grades (III and IV). It may cause symptoms of canal stenosis and nerve root compression.

Lumbar Slip Complications

Severe spondylolisthesis sometimes leads to another condition called cauda equina syndrome. This is a serious condition in which the nerve roots in a part of the lower back called the cauda equina are compressed. It may cause you to lose feeling in your legs. It can also affect the bladder. This is a medical emergency. If left untreated, cauda equina syndrome can cause loss of bladder control and paralysis.

Ways to Treat Lumbar Slipping

  • Treatment may include:
  • Rest, weight and activity restriction
  • Anti-inflammatory medications, including ibuprofen or naproxen
  • steroid injections
  • Strengthening supporting abdominal and back muscles with Physical Therapy
  • Supporting

If you continue to experience severe pain and disability after physical therapy, surgery may be an option.

In cases with mild slippage, facet blockade and injection treatments can be applied.

Surgical Treatment of Lumbar Slipping

In cases with high degree slippage or unstable slippages where excessive mobility is detected on dynamic radiographs, the spine is supported by applying screw plate systems, popularly called platinum, and support materials placed between the vertebrae, called wedges. The bone structure of the spine is strengthened with bone chips or synthetic ossification-enhancing materials (Fusion process).