SPINAL SURGERY

in Hull and East Yorkshire

GEORGE SPINK FRCS (Neurosurg.) BSc Hons

 

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SPONDYLOLISTHESIS - SLIPPED VERTEBRA

 

-      This rare spinal condition is one where the bones in the spine fall out of alignment.  This is called spondylolisthesis ('slipped vertebra').

-      It can be due to a congenital problem in the way the bones of the spine are formed. It can also occur after some spinal operations or due to excessive 'wear and tear' or spinal degeneration.

-      In many older patients with degenerative disease these slipped vertebra are fused and so may not benefit from surgery.

-      In younger patients the bones may still be mobile and moving on each other. These patients may benefit from surgery

-      Most patients with a slipped vertebra will complain of back pain. Some of this will be due to the 'wear and tear' changes in the spine. Some of the pain may also be due to the bones moving on each other.

-      Patients may also complain of problems in their legs. Again some of these symptoms will be referred problems from their spine. In other patients leg symptoms will be due to nerve being trapped in their back due to the slipped bones.

-       In addition to a careful outpatient assessment and examination you may require an MRI scan if your symptoms persist. An MRI scan uses a powerful magnet to create a picture of your spine. It does not involve any radiation exposure. The scanner itself is a long narrow tunnel, which some patients may find a bit claustrophobic. It is also fairly noisy during the scan.

-      It may also be necessary to consider a CT scan and dynamic x-ray imaging to get a clearer picture of the bones in the spine and any abnormal movements.

 

Treatments

-      Physiotherapy (aimed at improving core stability muscles to support the spine).

-      External bracing / support corset.

-      Nerve root blocks (highly selective radiology technique to help with leg pain).

-      Facet joint injections or epidural injections (may ease some of the back pain).

-      Nerve root decompression (may help leg symptoms but make back pain worse).

-      Complex spinal fusion (putting screws, rods and fusion blocks into the spine to stop the vertebra slipping any further).

 

Outcomes

-      None of the treatments will cure back pain.

-      Some will improve the back pain to make life more bearable.

-      In most patients a complex spinal fusion will improve their leg symptoms significantly but may make no difference to their back pain.