Anterolisthesis is an abnormal alignment of bones in the spine and usually affects the lower back. It is a medical condition characterized by the forward displacement of one vertebral body over the one below it. It occurs when an upper vertebra slips forward on the one below, leading to pain and other symptoms. It can occur in any part of the spine but is most commonly seen in the lumbar (lower back) region.
Symptoms of anterolisthesis
The symptoms of Anterolisthesis can vary depending on the degree of displacement and the location of the affected vertebra. It can cause constant and severe localized pain, or it can develop and worsen over time. Pain may be persistent and often affects the lower back or the legs. Common symptoms of Anterolisthesis include:
Lower back pain:
This is the most common symptom of Anterolisthesis, especially in the lumbar spine. The pain may be dull or sharp and may worsen with standing or walking.
Numbness or tingling:
Anterolisthesis can compress the nerves in the spinal column, causing numbness, tingling, or a pins-and-needles sensation in the legs.
Weakness:
Anterolisthesis can compress nerves and weaken the muscles in the legs, making it difficult to walk, stand, or climb stairs.
Stiffness:
It can cause stiffness in the lower back, making it difficult to move or bend.
Loss of bladder or bowel control:
In severe cases of Anterolisthesis, the compression of the spinal cord can cause loss of bladder or bowel control. This may be a sign of cauda equina syndrome, a neurological emergency, and you should seek medical attention immediately.
Causes
Anterolisthesis is often due to sudden blunt force or fractures. These can result from trauma typically experienced in an auto accident or a fall. It can also develop over time through strenuous physical exercise, such as bodybuilding.
Aging is another common cause of Anterolisthesis. This occurs naturally over time as the ligaments and joints that hold the vertebrae in proper position begin to weaken. This can create instability in some people and result in degenerative spondylolisthesis.
Anterolisthesis can also be linked to tumors. A tumor can force the vertebra to move from its natural position. Occasionally, Antirolisthesis is linked to a genetic spinal growth defect in children.
Diagnosis
Your doctor may order imaging tests to confirm the diagnosis and determine the severity of your spondylolisthesis. The most common imaging tests used include:
X-rays:
X-rays can show the alignment of the vertebrae and any signs of slippage.
CT scan:
A CT scan can provide a detailed image of the bones and soft tissues in your back, allowing your doctor to see any damage or abnormalities.
MRI:
An MRI can show the spinal cord or nerves, as well as any herniated discs or other soft tissue abnormalities.
Treatment
For those experiencing pain, oral medications are first-line treatments for Anterolisthesis. This includes non-steroidal anti-inflammatory medications (NSAIDs) such as ibuprofen, acetaminophen, or in severe cases opioids or muscle relaxants (with extreme caution). Topical medications such as lidocaine patches are also sometimes used.
Bed rest:
Bed rest can help overcome mild cases of Anterolisthesis. Participation in sports and strenuous daily activities should be stopped completely until the pain subsides. Rest can also help prevent further slippage or damage to the vertebrae.
Exercise:
Exercises are usually carried out in conjunction with physical therapy. Exercise can increase pain-free movement, improve flexibility, and build strength in the back muscles. Stabilization exercises can maintain the mobility of the spine, strengthen the abdominal and back muscles, and minimize painful movement of the bones in the affected spine.
Therapy:
Complicated symptoms may be treated with physical therapy, often alongside an exercise program. A brace or back support might be used to help stabilize the lower back and reduce pain.
Medication:
Non-steroidal anti-inflammatory drugs (NSAIDs) can help treat the pain and inflammation caused by Anterolisthesis, for more acute pain, steroids or opioids may be required. Epidural steroids injected directly into the back may reduce inflammation and ease the pain.
Surgery:
Surgery is a last resort in the treatment of Anterolisthesis. It may be necessary if the vertebra continues to slip or if the pain persists despite other treatments. Surgery may involve adjusting the vertebrae with plates, wires, rods, or screws.
Usually, one of the following surgical procedures is used to treat Anterolisthesis.
Decompression:
This is when bone or other tissue is removed to release pressure on the vertebrae and associated nerves.
Spinal fusion:
This is when a piece of bone is transplanted into the back of the spine. The bone heals and fuses with the spine. This creates a solid bone mass that helps stabilize the spine. A combination of decompression and spinal fusion may also be considered.
